As of January 15, 2022 most people with a health plan can receive COVID-19 tests authorized by the FDA at no cost, either through reimbursement or free of charge through an insurer. The federal order for this coverage requirement provides for each person to have up to eight tests covered per month without needing to visit a healthcare provider. For those with underlying medical conditions who receive an order from a healthcare provider, there is no limit to the number of tests. While the federal order incentivizes insurers to cover costs for at-home tests directly, they had limited time to create such a process and preferred network of stores. If a preferred network exists, you can purchase a test elsewhere, but only will receive up to $12 per test in reimbursement. To request reimbursement from your insurer, be sure to keep your receipt from the pharmacy or retailer. Contact your insurer with questions about the reimbursement process. Plans are not required to provide coverage for testing that is specifically for employment purposes.

A federal website will be launched on January 19, 2022 where residents can order free COVID-19 rapid tests. There is a limit of four tests per address, and tests are expected to ship between 7 and 12 days following the order. Visit covidtest.gov to register. At-home tests are also available for purchase at retailers and pharmacies. More information regarding insurance reimbursement for at-home tests is available in the prior FAQ question.

Visit https://de.gov/gettested to find a local testing site. Do not go to a hospital or emergency department to get a COVID-19 test.

State Medicaid and CHIP are already required to cover FDA-authorized at-home tests without consumer costs. Medicare pays for tests when ordered by a provider, and Medicare Advantage plan participants should talk to their insurer about options. Medicare-certified health clinics and community health centers have been provided up to 50 million free at-home tests from the federal government. For uninsured residents, the best option continues to be tests mailed by the government or testing at a site in-person.

There is a good possibility that the answer is “yes.” Starting April 1, 2021, many consumers are eligible for higher tax credit amounts to help cover their Marketplace health plan premiums.Instead of no premium tax credits for individuals and families making more than 400% FPL, ARPA will make premium tax credits available to these families and caps how much of a family’s household income the family needs to pay towards their premiums at 8.5%, based on the cost of the benchmark plan. Four out of five enrollees will be able to find a plan for $10 or less/month with premium tax credits, and over 50% will be able to find a Silver plan for $10 or less with tax credits.

Yes. Section 9501 of the ARP provides for COBRA premium assistance to help Assistance Eligible Individuals continue their health benefits. Assistance Eligible Individuals are not required to pay their COBRA continuation coverage premiums. The premium assistance applies to periods of health coverage on or after April 1, 2021 through September 30, 2021. An employer or plan to whom COBRA premiums are payable is entitled to a tax credit for the amount of the premium assistance. For more information and to determine if you are an Assistance Eligible Individual, go to the Federal FAQs about Cobra Premium Assistance under the American Rescue Plan Act of 2021 (April 07, 2021)

The American Rescue Plan says that, through September 30, 2021, those on COBRA (including state COBRA, aka “mini COBRA”) do not have to pay the premiums for their group health plan for individuals and their dependents. The employer must pay the premium and receive a tax credit. Eligibility for ACA subsidies or Medicaid does not prevent eligibility for this COBRA benefit. COBRA election is extended for those who refused COBRA or for which COBRA ended, though the 18-month limit is not extended.

This is a question the federal government, through CMS, is currently exploring.

The State of Delaware official vaccine information website is: de.gov/covidvaccine. There is also a Vaccine FAQ page that you may find helpful, or consider calling the Division of Public Health COVID-19 Vaccine Call Center at (302) 672-6150. The Call Center is operational from 8:30AM to 4:30PM Monday through Friday, and 10:00AM to 4:00PM on Saturdays. In addition, you can email questions to vaccine@delaware.gov.

No insurance is needed to get the vaccine.

Vaccine doses will be provided at no cost to you. Those administering the vaccine are able to charge a fee to your private insurance, or public insurance such as Medicare and Medicaid. These insurers are required to provide coverage for all office visit fees or administrative costs. Providers who administer vaccines to uninsured individuals may have this fee reimbursed by the Health Resources and Services Administration’s Provider Relief Fund. The department provided more information in a related immunization bulletin.

No. ARPA requires coverage, without cost-sharing, of COVID-19 vaccines and treatment under Medicaid and the Children’s Health Insurance Program (CHIP).

Yes. ARPA provides for additional funding for COVID-19 vaccinations, testing, treatment and prevention.

Several types of insurance have provisions and exclusions that may be triggered as a result of COVID-19, including health, travel, life, annuities, business interruption, event cancellation, worker’s compensation, general liability, and directors and officers liability. As with all insurance policies, you should review your policy documents, contact your insurance agent or broker for assistance, or connect with the Department of Insurance if you have questions. View the NAIC COVID-19 and Insurance guide for more information.

Visit the Coalition Against Insurance Fraud webpage  and the Better Business Bureau to learn about COVID-19 scams and how to protect yourself and your family from them. If you suspect you are the victim of an insurance scam or fraud, call our Fraud Hotline at 1-800-632-5154 or 302-674-7350, or email fraud@delaware.gov. Federal agencies have also shared information, including:

• U.S. Department of the Treasury information on COVID-19 Scams
• U.S. Department of Homeland Security information on COVID-19 Scams
• Federal Trade Commission information on COVID-19 Scams
• U.S. Department of Health and Human Services Fraud Alert

The following Federal Communications Commission (FCC) websites also contain additional information on scams:

• FCC Consumer Help Center
• FCC Consumer Warnings and Safety Tips
• FCC Consumer Complaint Center
• FCC Scam Glossary

For assistance, call our Consumer Hotline at 1-800-282-8611 or 302-674-7300, or email consumer@delaware.gov. At this time, we are not taking in-person meetings.For complaints, you can also fill out our complaint form and upload any relevant documents, and one of our investigators will contact you as soon as possible after you submit your form.

Delaware’s Division of Unemployment Insurance is housed under the Department of Labor. Due to high contact volume, they recommend emailing claim questions, along with your name and claim/confirmation number, to uiclaims@delaware.gov. You can file for unemployment benefits online. More information about unemployment insurance can be found on the Department of Labor Unemployment Benefits FAQ page.

Health insurance companies are activating emergency plans to ensure that their customers have access to the prevention, testing, and treatment needed to handle the COVID-19 crisis, as shared in a statement by America’s Health Insurance Providers’ (AHIP) Board on March 5. You can find your health insurance company in AHIP’s archive of company commitments to learn more about what they are doing to help. Additionally, insurers are operating their own FAQ pages:

• Aetna customers: view Aetna’s FAQ page.
• Cigna customers: visit the Cigna COVID-19 Resource Center.
• Highmark customers: visit Highmark’s FAQ page and Highmark’s April 2 Cost Waiver Announcement.
• United Health Care customers: view United Health Care’s FAQ page and United Health Care member support page.

Some prescription drug plans are relaxing the way customers can order their prescription drugs, including allowing 90-day refills and expanding mail-order or delivery options. You can find your health insurance company in AHIP’s archive of company commitments to find out more. Additionally, insurers may have information on their FAQ pages:

• Aetna customers: view Aetna’s Pharmacy page.
• Cigna customers: visit the Cigna COVID-19 Resource Center.
• Highmark customers: visit Highmark’s Pharmacy page.
• United Health Care customers: view United Health Care’s FAQ page and United Health Care member support page.

If a change in income or insurance coverage is impacting your ability to manage your diabetes, you can reach out to Healthy Delaware‘s Delaware Helpline, which provides referrals for residents in need of diabetes services, medications, or supplies. The Delaware Helpline phone number is 1-800-560-3372.

You can use telemedicine and telehealth to contact your doctors, including your primary care provider, mental health care providers, and other doctors whom you would normally see in person. You do not have to have seen a provider in-person or before relevant services may be provided, per the Governor’s orders, and if you are a Delaware resident who is out-of-state for some reason, you can still receive these services.

If you had employer-sponsored health insurance but are no longer covered because your employer has permanently closed, you may be eligible to enroll in the health insurance marketplace. Loss of group insurance can create a qualifying enrollment event. You must enroll within 60 days from when your employer-issued health insurance ended. You can contact a local navigator, visit Healthcare.gov, or call (800) 318-2596.

You can contact a local navigator, visit Healthcare.gov, or call (800) 318-2596 to see if you are eligible for cost sharing and premium tax credits based on your income. In some cases, you may also be eligible for Medicaid. Depending on your 2020 tax return and your income to date, you may have to estimate what your income will be for the tax filing year of 2021. If you are eligible for tax credits and cost sharing, it will be reflected in reduced premium and deductible amounts.

You can check your eligibility and apply for Medicaid using ASSIST online. ASSIST is an online application for Delawareans to apply for health and social service programs.

If you already contacted a local navigator, visited Healthcare.gov, or called (800) 318-2596 and found out that you are not eligible for cost sharing and/or premium tax credits, there are other alternatives for health insurance that cover a three month period. While we do not often recommend short-term limited benefit health insurance policies, during this time it may be an option for you. Please be aware these plans do not provide coverage for pre-existing medical conditions – anything that you have been diagnosed with or sought treatment for within the past five or more years. These plans only cover a limited number of doctor visits for a limited dollar amount, and may have very high deductibles and copay requirements. These plans do not qualify for or replace a major medical, ACA-approved health insurance policy. These types of policies are only effective for three months and are not renewable.

If you bought your own health insurance and are now unable to make your monthly premiums due to being out of work or working fewer hours, your insurance company may not terminate your coverage during the Delaware State of Emergency. The Governor and Insurance Commissioner have informed insurance companies that they are not permitted to terminate or not renew your insurance during the Delaware State of Emergency due to payment-related issues without a court order. Please note that you will need to contact your insurance company to explain why you are suffering a hardship and cannot make your premium payments in full or on time.

Once you return to work or start and new job, and your employer tells you the date that they will start offering health insurance to employees, you may want to sign up for coverage under your employer’s plan. If you choose to enroll in your employer’s plan, avoid duplicate coverage by notifying your insurance company in writing 30 days before you are terminating your individually purchased health insurance and list the date your employer-sponsored policy will become active.

You may be able to continue to cover your employees, depending on whether there are minimum-number-of-employee requirements on your plan. Reach out to your insurer to discuss options.

Please read your travel insurance policy carefully to determine your coverage, and contact the company you bought it from to discuss, or to file a claim. If the claim is denied, you can ask if the insurer provides an internal appeal process to further dispute the denial.

Many companies have had to shut down temporarily due to the COVID-19 pandemic with little time to prepare. Still, a lack of on-premises work activity does not mean reduced risk. Improper action or negligence when decommissioning facilities can bring risk for companies, as can idle premises. Consider reviewing general security and prevention measures to help avoid physical damages, such as regular checks of fire protection systems, and storing all materials safely. You may want to access a security provider, and implement remote monitoring technologies. Allianz Global Corporate and Specialty (AGCS) provides suggestions in their Safety Measures for Businesses Forced to Temporarily Close their Premises publication. Make sure to read your insurance policy, and understand coverage for your business property. Contact your insurance company with any coverage questions.

Business interruption insurance protects against losses sustained due to periods of suspended operations, and pays loss of revenue that would have been earned if the business operated continuously. Typically, policies require physical damage to the property for payment, and many policies have specific exclusions for viral infections, like COVID-19. Contingent business interruption policies similarly protect against losses due to disruptions in the supply chain, but these policies may require physical damage to the property for payment, and many policies have exclusions for communicable diseases, like COVID-19. We urge you to read your policy carefully to determine the initial scope of coverage that your policy provides for business interruption and associated expenses, and carefully review exclusions or conditions that would limit the coverage. Consult your insurance company with any questions.

When permitted to reopen workplaces and businesses to employees and customers, safety precautions must be taken. The United States Department of Labor Occupational Safety and Health Administration website offers a dedicated hub of resources for various workers and employers, as well as industry-specific information and guides in multiple languages. They have also released Guidance on Preparing Workplaces for COVID-19, which outlines a number of steps employers can take to ensure safety.

• March 10: Commissioner Navarro Issues Bulletin to Insurers Regarding Coronavirus – read the full bulletin.
• March 20: New Bulletin Provides Recommendations to Insurers During COVID-19 – read the full bulletin.
• March 24: Commissioner Navarro Statement on Sixth Modification to State of Emergency – read the Governor’s sixth modification to the State of Emergency.
• March 26: Updated bulletin to insurers with information from the Governor’s actions
• April 1: Bulletin regarding Private Passenger Automobile Liability Coverage
• April 3: Bulletin regarding Compliance with Regulatory Requirements During COVID-19
• April 7: Navarro Praises Consumer-Friendly Auto Insurer Actions
• April 9: Bulletin regarding Regulatory Filing Requirements
• April 28: Bulletin regarding Delays in Workplace Safety Premium Credits
• April 29: Reduced Driving leads to Rebates, Reimbursements, and Reduced Rates for Delaware Residents
• July 25: Updated bulletin regarding Regulatory Requirements
• July 2: Bulletin updating Cancellation and Nonrenewal Prohibition, Repayment Terms
• December 21: Bulletin regarding Immunization Availability and Coverage
• August 2, 2021: Universally Applicable Bulletin 6

We’ve stopped allowing public entry to our offices to protect our employees, but are always happy to help. If you’re experiencing an insurance issue related to coronavirus, call our office at 302-674-7300 or email us at consumer@delaware.gov. Individuals who have lost their jobs and no longer have employer-sponsored insurance may be able to purchase a healthcare plan on the marketplace. Go to choosehealthde.com to learn more. If you think you may be experiencing symptoms, contact the Division of Public Health hotline at 1-866-408-1899. Visit de.gov/coronavirus for more information. If you are an insurer who would like to provide information for inclusion in our FAQ’s, please email christina.haas@delaware.gov.