The waiver would have shut the door on the most popular pathway for enrollment – healthcare.gov, said Laura Colbert, executive director of Georgians for a Healthy Future. “Consumers will have…
Updated: December 18, 2020
The Georgians for a Healthy Future team is continuing to monitor the COVID-19 (coronavirus) outbreak closely. As always, GHF strives to be a resource for Georgia consumers. While things continue to change quickly during this health care pandemic, we will share practical advice and actionable information to help you navigate a confusing time and find the answers you need. Here we present information about how to access health care services and what to expect from your health insurance coverage when you do. We will keep the corresponding blog post updated as things change and with links to helpful resources as they become available.
Georgia’s statewide shelter in place ended on April 30, 2020 for most Georgians. Vulnerable populations including those who are medically fragile and elderly should continue to shelter in place until June 12, 2020.
Governor Kemp also extended Georgia’s public health state of emergency through January 08, 2020. He also issued executive orders requiring businesses to operate by strict social distancing and sanitation rules through May 13, 2020. As of June 1, 2020 restaurants are still required to abide by 39 restrictions to open their dining rooms.
We encourage all of you to continue to help prevent the spread of the virus by taking the necessary steps to “flatten the curve” including staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
If you are experiencing symptoms of COVID-19 or may need a test
If you believe that you are experiencing symptoms of COVID-19 or have been exposed to the novel coronavirus, call your primary care doctor or an urgent care clinic. Let them know you think you may have COVID-19, so they can take the proper precautions and direct you to available testing sites. You may also call the Georgia Department of Public Health on their COVID-19 hotline at 844-442-2681. Public health officials are urging people not show up unannounced at a doctor’s office, emergency room or other health care facility.
The Centers for Disease Control and Prevention have a Coronavirus Self-Checker which may be a helpful tool if you think you are experiencing symptoms of the virus.
You can find out more about COVID-19, its symptoms, what to do if you think you are sick, and other COVID-19 information at dph.georgia.gov/novelcoronavirus.
COVID-19 testing is available for all Georgians, regardless of whether you have coronavirus symptoms. Anyone can call their local health department to get scheduled for testing. They can also download the Augusta University ExpressCare app, visit augustahealth.org, or call (706) 721-1852.
Effective May 7, 2020, COVID-19 testing is available to all Georgians who request it, whether they have symptoms or not. Call your local health department to schedule an appointment at a location near you and to inquire if testing is free.
What to expect from your health insurance
If you have insurance, make sure to use it for any testing and medical exams related to COVID-19 and any other medical services you may need during this time.
The COVID-19 crisis has caused many Georgians to lose their jobs and also lose their employer-sponsored health care coverage. If you have lost your coverage or have had a drop in your income, you may be eligible for Medicaid or financial assistance to buy health insurance through the Affordable Care Act. Please read the If You Lose Your Job section below.
If you have Medicaid or PeachCare for Kids
If you and your family have lost your source of income in this crisis, or are in lower-income work with no health coverage, enrolling in Medicaid may be an option for you.
Medicaid provides all “medically-necessary” services to its members. During the national public health emergency period, your Medicaid coverage will cover the cost of a COVID-19 test. If you are diagnosed with COVID-19 and need medical treatment, Medicaid should also cover those costs.
If you need other health care services during this time, check with your Medicaid insurance company and doctor to see if you can have a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person.
Georgia’s Department of Community Health (DCH) has announced that Medicaid & PeachCare members will not owe any co-payments for any health service from May 1, 2020 until the end of the national public health emergency.
No one can willingly lose their Medicaid coverage during the public health emergency. If you lose your Medicaid coverage during this time, contact your Medicaid insurance company.
If you have private insurance
If you have insurance through your job, the State Health Benefit Plan, or the Affordable Care Act marketplace (also called healthcare.gov), use it for any testing or medical exams related to COVID-19. The Families First Act requires that health plans and insurers cover testing for COVID-19 so your test should be free. If someone wants to charge you for a test, call the DPH’s COVID-19 hotline.
If you are diagnosed with COVID-19 and require medical treatment, you should expect to pay some out-of-pocket costs like your deductible.
As of March 21, 2020 Cigna, Humana, Aetna, and UnitedHealthcare have waived cost-sharing for COVID-19 treatment. Aetna and Cigna have pledged to waive COVID-19 treatment costs for qualified medical bills until June 1, 2020. Humana has not announced an end date to their COVID-19 cost-sharing policy.
If you purchased coverage outside of the ACA marketplace or you have a short-term plan or health-sharing ministry, call your insurance company to find out how they are covering COVID-19 testing and treatment. The cost-sharing requirement under the Families First Act does not apply to people who are enrolled in non-ACA compliant plans (ex: short-term plans).
If you need other health care services during this time, check with your insurance company and doctor to see if you can have a “virtual appointment” using the internet, a video call, or a telephone call instead of going in-person.
In order to ensure people affected by COVID-19 have access to health care Georgia’s Insurance Commissioner issued a directive on March 20, 2020, that instructed health insurers to refrain from canceling health policies due to non-payment. That directive expires on May 31st. If you are behind on your premium payments or expect to be, call your insurance company right away to see if they can offer a payment plan, financial assistance, or other help to keep you enrolled.
If you have Medicare
Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs. All necessary hospitalizations are also covered by Medicare, including hospitalizations for quarantine. More information about Medicare’s coverage and services is available here.
If you are uninsured
If you need a COVID-19 test, contact your local public health department to find a testing site and to ask whether the test will be free. Request that they waive any testing costs.
If you need other health care services during this time, find a local community clinic, or apply for financial assistance through a hospital charity care program. Georgians should not let their insurance status get in the way of getting needed testing or treatment.
If you lose your job
Many Georgians across the economy have lost their jobs and may be at risk of losing their coverage. If this is your situation, you can keep yourself and your family covered during this health crisis. You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. When you begin the enrollment process, healthcare.gov will ask you about your estimated income for 2020 and will let you know if you qualify for financial help to lower your premiums and other cost-sharing.
For free help with the enrollment process, contact these organizations:
- Insure Georgia, insurega.org, 866-988-8246
- The Health Initiative, thehealthinitiative.org, 404-688-2524 (leave a voicemail in the general mailbox)
Coverage through the ACA marketplace (healthcare.gov) covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Call your insurance company for more information.
If you are unable to enroll in a health insurance plan, you may have other options through services such as a community clinic, which can connect you with the care you need.
Resources for you and your loved ones
During this uncertain time, many of our partner organizations are doing the hard work of finding and centralizing the information that you and your loved ones may need. Here are a few that we think are most helpful. We will continue to update this list with actionable resources and information so you can stay healthy, safe, and well.
- COVID-19 guidance and information
- Information from public health experts: Visit the Georgia Department of Public Health’s website for the latest guidance and updates about COVID-19 in Georgia.
- Coronavirus resources for people who are not strong readers: Georgia State University has published a library coronavirus materials for people who may not have strong reading or literacy skills. They have included materials up to a 9th-grade reading level.
- COVID-19 guidance and information for people who do not speak English as a first language:
- Google Drive folder with resources in 20 languages, collected and maintained by the Center for Pan Asian Community Services
- The GSU School of Public Health’s Prevention Research Center has compiled COVID-19 information sheets (from CDC & the International Rescue Committee) in 25 languages
- Make sure your basic needs and finances are taken care of:
- If you need help finding food:
- Food Bank of Northeast Georgia: Visit www.foodbanknega.org, click “Need Help”. Call the office at (706) 354 8191
- Atlanta Community Food Bank: Text the word FINDFOOD to 888-976-2232 with your ZIP code and street address and you will be sent a list of the three closest distribution centers.
Text service also available in Spanish, using the word COMIDA
- Georgia Mountain Food Bank: uses the same system as Atlanta Community Food Bank
- Golden Harvest Food Bank Visit www.goldenharvest.org, click on ‘Find Help’ at the top of the page, you will be taken to a map where you can enter your zip code to find the nearest food distributor
- Middle Georgia Community Food Bank–Call 211 and you will be connected with an associate who will be able to tell you where you can find food
- Feeding the Valley Food Bank: Visit feedingthevalley.org, on the front page, enter your zip code into the ‘Need Food’ box and you will be shown the closest food pantries to your location
- America’s Second Harvest of Coastal Georgia: Visit helpendhunger.org, select ‘Find Food’ on the homepage, you will be taken to a map where you can enter your zip code or county to be shown the nearest food distribution centers
- Second Harvest of South Georgia: Visit feedingsga.org, select ‘Find Help’ in the ‘Learn’ section at the top of the page, you will be taken to a map where you can find the closest distributors to you
- COVID-19 stimulus payments: The IRS has published a way for people to receive their recovery refund (also called COVID-19 stimulus payments) even if you were not required to file taxes in 2019. Details are available here.
- Avoid scams: What Consumers Need to Know About COVID-19 Scams, Georgia Watch
- Direct financial assistance: Patient Advocates Fund’s COVID Care Recovery Fund delivers $500 in direct financial aid to eligible patients who need non-medical, cost-of-living help as a result of their diagnosis of COVID-19.
- Financial health during COVID-19: Financial Resilience Center, National Disability Institute
- Health Care:
- Resources for people with developmental disabilities:
- COVID-19 Resources for Georgians with Developmental Disabilities, Georgia Council on Developmental Disabilities
- Staying mentally healthy and keeping your recovery: Behavioral Health in the time of COVID-19 by Georgians for a Healthy Future
- Keeping children healthy and well:
- COVID-19 latest information and resources, Voices for Georgia’s Children and Georgia Statewide Afterschool Network
- Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life
- Transitioning Into Your Family’s New “Normal”, Children’s Healthcare of Atlanta
- Five-Minute Coronavirus Stress Resets, The New York Times
- Resources for pregnant families during COVID-19: Healthy Mothers, Healthy Babies Coalition of Georgia has put together a toolkit for families navigating pregnancy, labor, and the postpartum period in Georgia during COVID-19
- Community Health Workers
- Information and Resources for Community Health Workers: This information kit was created for CHWs serving in Georgia to supplement the robust list of information provided by the National Association of Community Health Workers.
Sherry is 77 years old and lives independently in Murray County in north Georgia. She gets up five days a week at 5 am and prepares for her day, which begins with a bus ride to the RossWoods Adult Day Center. Medicaid and Medicare make it possible to spend her weekdays at RossWoods where she engages in arts and crafts and social activities designed to keep her brain and body healthy. She also receives information about her medications and doctor’s appointments. Sherry is one of over half a million seniors and people with disabilities in Georgia who depend on Medicaid and Medicare to live and function in their communities.
Sherry has several health conditions including high blood pressure, a blood clot in her heart, chronic obstructive pulmonary disorder, a pacemaker, and arthritis in one of her legs. On top of all that, she recently fell and broke her wrist, causing nerve damage. Thanks to Medicaid, Sherry is able to afford the medications she needs to live a functional and healthy life. She would not have the financial means to pay the standard $30–$50 copay for each of her seven medications but Medicaid means she pays just $1.20 per medication instead.
To get to the pharmacy for her medications, doctors’ appointments and RossWoods, a type of Medicaid called the Community Care Services Program (CCSP) waiver provides Sherry with transportation. CCSP waivers provide “community-based social, health and support services to eligible consumers as an alternative to placement in a nursing home.” When asked about her Medicaid coverage, Sherry said: “I couldn’t make it if I didn’t have [Medicaid]. There would be no way.”
For 168,000 seniors like Sherry who typically live on low, fixed incomes, Medicaid makes the difference and helps to pay the costs of their Medicare coverage. For some, it provides additional health benefits not covered through Medicare. For others, Medicaid allows them to age with dignity in their communities by covering needed home and living adaptations like chair lifts, wheelchair ramps, or engaging day programs with trained staff.
As we continue to celebrate the 1 year anniversary of the Affordable Care Act, we look to the changes that affect senior citizens and highlight how far we’ve come in just one year. One of the first provisions to take effect under the new law was the beginning of the closing of the Medicare donut hole. (more…)
By Mike King
The current controversy over closing Grady Memorial Hospital’s outpatient kidney dialysis clinic is indicative of more than just the struggling Atlanta hospital’s hard choices about what services it can afford to make available for the region’s poor and uninsured.
While much of the focus on the closing has centered on what to do about the illegal immigrants who depend on Grady’s dialysis unit, the pathology of the problem lies within flaws in the nation’s complicated and – at times nonsensical – policies for covering end-stage kidney disease.
To fully understand Grady’s dilemma, it helps to understand how we got here and why we’re stuck now.