Insurance Commissioner issues bulletin addressing coverage for COVID-19 testing, including antibody testing

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Categories: Coronavirus

Insurance Commissioner Jon Godfread today announced the issuance of Bulletin 2020-10 addressing coverage for COVID-19 (coronavirus) testing in response to Executive Order 2020-03 by Governor Doug Burgum. This new bulletin builds upon Bulletin 2020-1.1 in which health carriers and travel insurers are asked to identify and remove barriers to testing and treatment for COVID-19.

“The consequences of the potential spread of COVID-19 could have a dramatic impact on North Dakota and our citizens,” Godfread said. “It is essential that government and business leaders take the appropriate steps to safeguard the health and wellness of North Dakotans. Health insurance coverage plays a critical role in both. Bulletin 2020-10 encourages insurance carriers to continue doing their part by covering the expense of medically necessary testing for insured individuals. Health insurance will continue to support medically necessary treatments and testing; however, health insurance should not be expected to cover public health surveillance or employment screening programs. Those testing operations need to be paid for by either state and federal government or employers seeking this testing.”

Bulletin 2020-10 Antibody Testing – COVID-19

Issued on May 18, 2020, to notify all insurance carriers offering health benefit plans and self-funded plans regarding coverage for COVID-19 testing and treatment. At present, the Insurance Department is aware of three types of COVID-19 tests: 

  • Polymerase Chain Reaction (PCR) tests look for the presence of the unique DNA of COVID-19 in a patient. 
  • Antigen tests look for a unique part of COVID-19, such as a specific protein on one of the unique COVID-19 spikes.
  • Antibody tests (also known as serology tests) look for the presence of antibodies in a patient’s immune system that may fight off COVID-19.

The issuance of Bulletin 2020-10 places the expectation that carriers cover PCR and antigen tests designed to detect the presence of COVID-19 when a patient’s symptoms indicate the medical need to conduct a test. In addition, the Insurance Department expects carriers to cover antibody tests only when such tests are medically necessary in order to support diagnosis or treatment for COVID-19 or for treatment of another disease when information about COVID- 19 antibodies may impact the future outcome of that treatment for an individual. It was further clarified that public health surveillance testing or employee screening are not considered to medically necessary.

“Our health insurance industry has stepped up to the plate by expanding services and waiving cost sharing for testing and treatment related to COVID-19 and will continue to cover those tests and treatments. These protocols are developed in support of our medical professionals, but regarding public health data and employment screening those responsibilities have always rightfully remained with government or the employers seeking that screening.”

To read the bulletin in its entirety, visit insurance.nd.gov/bulletins. Individuals with questions related to this bulletin should contact the Insurance Department at insurance@nd.gov.

For the latest information and updates related to COVID-19, please visit the Insurance Department website at insurance.nd.gov/covid-19-coronavirus-and-insurance, the NDResponse website at ndresponse.gov, and the CDC website at cdc.gov/coronavirus.

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