Coronavirus (COVID-19) information

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The Health Consumer Alliance can help you access health care during the coronavirus (COVID-19) pandemic. Please read our Q&A below for details about your rights. Call our toll-free hotline at 888‑804‑3536 (TTY 877‑735‑2929) for a free, confidential consultation.

• Do I have to pay for a coronavirus testing and screening?
• Does my insurance have to cover coronavirus treatments?  What about Medi-Cal?
• Does Medicare cover coronavirus treatments?
• Will getting coronavirus testing or treatment hurt my immigration status?
• What about nursing homes and long-term care?
• How can I get or keep Medi-Cal or Covered California during the pandemic?
• What if I get health care from a county program like CMSP, Path to Health, or My Health LA?
• How can I access medical care during the pandemic?
• How can I get dental care during the pandemic?
• How can I access behavioral and mental health care?
• How can I access other health benefits like CBAS, IHSS & Regional Center Services?
• Watch out for coronavirus treatment scams!
• Where can I get help with my health insurance and coronavirus?
• What if coronavirus is causing problems with my job?

Do I have to pay for a coronavirus testing and screening?

Under new federal law, all health insurance plans in California are required to cover the entire cost of coronavirus (COVID-19) testing and screening. Medi-Cal covers testing and emergency treatment (including outside hospitals) for free to all Californians who qualify based on their income. If your income is too high for Medi-Cal, a special “presumptive eligibility” program covers testing and treatment for free — regardless of immigration status.

This means that Californians will not have any out-of-pocket expenses or co-pays and deductibles, even if they receive testing and screening at hospital emergency rooms and urgent care facilities.

If you have no health insurance, you can still get free or low-cost testing. Contact county public health departments and your local clinic to receive information about your options for testing and screening for the coronavirus now. Even restricted-scope (or “emergency”) Medi-Cal covers COVID-19 testing and emergency treatment (even outside hospitals). 

Additional information is available at www.covid19.ca.gov, the California Department of Public Health, the California Department of Health Care Services (DHCS), and the Centers for Disease Control & Prevention.​​

Does my insurance have to cover coronavirus treatments?  What about Medi-Cal?

The California Department of Health Care Services (DHCS) issued reminders to all Medi-Cal health plans that they must take steps to provide no-cost care to members seeking testing, screening, and treatment for coronavirus. The California Departments of Managed Health Care (DMHC) and Insurance (CDI) issued similar reminders.

Under these directives, most California health plans should:

• Eliminate out-of-pocket expenses for all coronavirus testing and screening (even before coronavirus, Medi-Cal covered all testing and treatment for free);
• Waive prior authorization requirements for services related to coronavirus testing, screening, and treatment (all prior authorization requirements are waived for “regular” or “fee-for-service” Medi-Cal beneficiaries not enrolled in managed care plans);
• Waive prescription drug prior authorization requirements and lift quantity limits (Medi-Cal covers “off-label” and “investigational” medications if doctors prescribe them to treat COVID-19);
• Allow out-of-network access to medical care and prescription drugs; and
• For Medicare Part D plans, Medi-Cal and most other health plans, you can get at least a 90-day supply and have your prescription drugs mailed to you if you do not want to go to the pharmacy. AIDS Drug Assistance Program (ADAP) patients may get drugs delivered or mailed from certain pharmacies.

These requirements include Medi-Cal, Covered California, and all health plans regulated by DMHC and CDI. Medi-Cal also has special rules that will help you access prescription drugs.

Does Medicare cover coronavirus treatments?

Yes! Lab tests should be free, and Medicare covers outpatient and medically-necessary hospitalizations. For more information, click here.

If you have a Medicare Advantage Plan, you should have access to out-of-network care and services if needed. Plans can suspend prior authorization requirements. Plans may also waive co-payments and reduce other out-of-pocket costs.

Part D plans can lift limits on prescription drug refills and use mail or home delivery options for members staying at home. Part D plans can also waive prior authorization requirements. For more information, see this memo from the Centers for Medicare & Medicaid Services. When the government approves a coronavirus vaccine, Medicare Part B and all Medicare Advantage Plans must cover it at no cost to you.

As of March 17, Social Security Administration (SSA) offices are closed to in-person visits, but you can contact them by phone and access online services. Visit the Center for Medicare Advocacy for helpful tips on enrolling in Medicare while SSA offices are closed.

Will getting coronavirus testing or treatment hurt my immigration status?

Using Medi-Cal for coronavirus testing or treatment is the same as for any other medical condition. For most immigrants, simply having Medi-Cal will not harm their immigration status. That’s because many immigrants are excluded from the new public charge rule. Other immigrants have Medi-Cal that the rule does not count. Click here for more information.

The new public charge rule will not consider treatment and testing for coronavirus (even if Medi-Cal pays for the testing and treatment) for immigration applications processed in the United States. The new public charge rule also excludes getting help (for “communicable diseases” like coronavirus testing and treatment) from your local public health agency. County indigent health programs, like My Health LA, Healthy SF, HealthPAC, and the County Medical Services Program (CMSP), are also excluded. So most immigrants should be able to access coronavirus testing and treatment without it impacting their immigration status.

Under federal guidelines, all health care facilities (hospitals, clinics, doctor offices, urgent care facilities, and more) are off limits for immigration enforcement agents. This means Immigration and Customs Enforcement (ICE) should not arrest people or enforce immigration rules at health care facilities. 

For more information, read the California Department of Public Health’s special “Immigrant Communities Guidance” the California Immigrant Policy Center’s “COVID-19 Resource Guide for Immigrants in California,” the Immigrant Legal Resource Center’s “Coronavirus Care & Immigration” flyers in English and Spanish, and the Protecting Immigrant Family Campaign’s guide: “Immigrant Eligibility for Public Programs During COVID-19.”

What about nursing homes and long-term care?

Nursing homes may limit visitors to protect residents from the virus. The Centers for Medicare & Medicaid Services issued guidance on March 13 that restricts visitor access. But you should still be able to communicate with your loved ones. Check out California Advocates for Nursing Home Reform (CANHR)’s COVID-19 News & Resources website for trustworthy alerts and information. You can also contact your county’s long-term care ombudsman for help.

During the pandemic, there are special rules to help people with Medicare and/or Medi-Cal access nursing homes and long-term care:

• You no longer need to be hospitalized for at least three days before entering a nursing facility; and
• If you already exhausted your skilled nursing facility (SNF) days, you can get more days without starting a new benefit period.

How can I get or keep Medi-Cal or Covered California during the pandemic?

On March 12, California issued details on the special requirements to process Medi-Cal applications and renewals during the pandemic. All Medi-Cal renewals are suspended until June 16, 2020. This means your Medi-Cal should stay active through at least that date, even if your situation changes. And if you are applying for Medi-Cal, your application should be processed quickly.

• Getting on Medi-Cal: Because of coronavirus, people may be newly eligible for Medi-Cal after job loss and/or reduction in earnings. Your Medi-Cal application must be processed quickly if you have immediate medical needs. Apply for Medi-Cal by mail, phone, and online now at Covered California and learn about more coverage options here.
  • California requires counties to process Medi-Cal applications quickly if you have a medical need.
  • The application requirements are less strict. For example, if you don’t have access to all required documents (such as proof of income), a signed and dated written statement, under penalty of perjury, can be used in place of requested verification documents (except for citizenship and immigration status).
  • If you don’t have paper documentation of citizenship or immigration status, your Medi-Cal application should still be processed. So you should get Medi-Cal approved and access to medical care while you work to turn in the documents.
  • Applicants experiencing homelessness simply need to write that on their Medi-Cal application, and it will be enough to prove residency.
  • You can get expedited Medi-Cal through Hospital Presumptive Eligibility (60 days of immediate eligibility), the CHDP Gateway, Pregnancy Presumptive Eligibility, and other channels. All presumptive eligibility channels must accept applications by phone, including with telephonic signatures.
    
• Keeping Medi-Cal active: If your Medi-Cal annual renewal is due, counties must keep your Medi-Cal active even if your situation changes or you don’t turn in information. If your Medi-Cal was terminated, the county must reactivate your Medi-Cal. And like for new applications, you can submit a signed and dated written statement, under penalty of perjury, whenever you cannot find the verification documents the county says it needs (except for citizenship and immigration status).
  • Will you receive extra (“pandemic”) federal unemployment compensation? Medi-Cal does not count the $600 monthly of federal pandemic unemployment compensation, so it should not impact your Medi-Cal eligibility.
  • Will you receive a recovery rebate payment? Recovery rebate payments will be issued to eligible households based on estimated tax liability: up to $1,200 for each adult and $500 for each child. These recovery rebates are tax credits so Medi-Cal will not count them as income, or as resources for 12 months after the month you get the rebates.
    
• Medi-Cal monthly premiums: If coronavirus (COVID-19) is impacting your household, the state should not require you to pay monthly premiums for Medi-Cal, the Medi-Cal Access Program (MCAP), or the County Children’s Health Initiative Program (CCHIP). When you get your monthly premium bill, follow the instructions to ask to skip paying your premium because of coronavirus or call these numbers:
  • Medi-Cal Access Program (MCAP): 1-800-433-2611
  • Medi-Cal Access Infant Program (MCAIP): 1-800-880-5305
  • Medi-Cal monthly premiums for children (OTLIPC): 1-800-880-5305
  • County Children’s Health Initiative Program (CCHIP): 1-833-912-2447
    
• Medi-Cal State Fair Hearings: The deadline to request a Medi-Cal fair hearing is extended to 210 days after the date of your notice. During the pandemic, the state is only holding hearings by phone through May 15, 2020. But you still have a right to an in-person hearing. So when the state contacts you, you can request an in-person hearing for the future. While you wait for your hearing, your Medi-Cal services should remain active. If you need an in-person hearing before May 15 or help requesting a hearing during the 210-day extended request period, contact the Health Consumer Alliance: 888‑804‑3536 (TTY 877‑735‑2929).
  
• Family PACT: The Family Planning, Access, Care, and Treatment (FPACT) program provides family planning services. Providers can now enroll and renew participants through phone and telehealth, instead of in-person office visits. The provider must allow you to pick up your Health Access Programs (HAP) card, or mail it to your verified address.

• Minor Consent Medi-Cal: If you are under age 21, you can get coverage for some Medi-Cal services (family planning, substance use, and outpatient mental health) without your parents knowing. During the pandemic, you can apply by phone and get by phone all information you need to access care.
  
• Every Woman Counts (EWC): Providers must accept applications and recertifications by phone, including with telephonic signatures. This means you should be able to access and continue with EWC’s free breast and cervical cancer screening and diagnostic services without turning in paperwork.
  
• Covered California: Sign up for a Covered California plan through June 30, 2020 at www.coveredca.com. For more information on this special enrollment period, click here.

What if I get health care from a county program like CMSP, Path to Health, or My Health LA?

CMSP (County Medical Services Program) & Path to Health must keep your eligibility active through June 2020.

• They cannot cut off your CMSP or Path to Health eligibility during that time.
• CMSP and Path to Health cover all COVID-19 diagnostic testing for free, even if you have a share of cost.
• CMSP and Path to Health does not require an in-person application at a clinic. They accept telephonic signatures.

My Health LA must keep your eligibility active through April 26, 2020.

• They cannot cut off your My Health LA eligibility during that time.
• My Health LA does not require an in-person application at a clinic, or paper delivery of renewal materials. They accept telephonic signatures. But you might still need to turn in paper proofs within 30 days.

What can I access medical care during the pandemic?

Many medical offices are carefully screening patients for symptoms of coronavirus. Some may cancel or postpone care as an extra precaution. But most plans cannot delay or cancel your treatments if it would harm your health. If that happens, call your health plan and ask for help. You can also ask your medical provider if they will talk with you by phone instead. Most health plans must provide “telehealth” (by phone or other virtual communication) including all Medi-Cal providers and plans and Family PACT providers. Medicare also covers “telehealth” and check-ups by phone.

• More information about telehealth in the National Health Law Program’s helpful analysis of telehealth rules for private health plans and Medi-Cal (health plans and fee-for-service).

If you have Medi-Cal, your doctor must talk with you before postponing or cancelling any treatments, and must first consider any negative effects on your health. State guidance says they should not cancel or postpone medically-necessary treatments, “including but not limited to all acute emergency procedures, procedures necessary due to acute, debilitating symptoms, pregnancy-related services, labor and delivery, organ transplantation, dialysis, cancer treatments, neurosurgery, trauma, cardiac treatment and limb threatening vascular surgery.” And the California Surgeon General asks Medi-Cal providers and health plans to coordinate your care and link you to services you need to stay healthy.

Important: now is not the time for our medical community to ration care for people with disabilities. The Disability Rights Education & Defense Fund (DREDF) reminds us that “longstanding federal and state nondiscrimination laws…prohibit such rationing measures when they result in the denial of care on the basis of disability to an individual who would benefit from it.” In response, the State of California clarified that “rationing care based on a person’s disability status is impermissible and unlawful under both federal and state law.”

• Download “Know Your Disability Healthcare Rights” information sheets in English/Spanish and English/Chinese for more information.
• Check out Communication First’s COVID-19 Communication Rights Toolkit if you need communication tools and supports due to speech-related disabilities.

Medi-Cal managed care plan appeals: For Medi-Cal plan members, your plan must process an expedited appeal within 72 hours. Contact your Medi-Cal plan to request an appeal. If you want to file a State Fair Hearing after that, you now have 240 days to do so. If your deadline to file a State Fair Hearing already expired after March 1, 2020, you now have an extra 120 days to file for a hearing.

How can I get dental care during the pandemic?

Dentists are screening patients for coronavirus (COVID-19) symptoms. Also, they may cancel or postpone your appointments and treatments because office staff are not able to get to work. The California Dental Association told dentists they should continue to provide care for dental emergencies. So if you have pain, an infection, or need dental care now because waiting would negatively impact your health — you should continue to receive it. If you already have a dentist, they should be available when their patients have dental emergencies. If they are closed, your dentist should refer you to another dentist who is open.

The American Dental Association (ADA)’s patient flyer and guidance to dentists list specific dental treatments you should continue to receive during the pandemic. Like for medical care, Medi-Cal dentists can treat you by phone call or video (“teledentistry“).

If you have Medi-Cal, it may be hard to find a dentist during the pandemic. You can search for Medi-Cal dentists here (select “Show only providers accepting new patients”). Contact the Medi-Cal Dental Telephone Service Center for assistance: 1-800-322-6384. If you had a Medi-Cal authorization for dental treatment but it expired, your Medi-Cal dentist should still accept the expired authorization.

• Not sure if you have a dental emergency so you can see a dentist during the pandemic? Check out this Medi-Cal Dental Member Bulletin for details.

How can I access behavioral and mental health care?

The Disaster Distress Helpline​ is open 24 hours every day and ready to help if you are feeling stressed, anxious or uneasy: (800) 985-5990. You can also text “TalkWithUs” to 66746 to connect with a trained crisis counselor.

Medi-Cal covers behavioral and mental health care. If you get care from your county, you can ask for treatment by phone or video without leaving your home. You can also get a long-term supply (up to 100 days) of prescription drugs. You can ask for an early refill if you have already used at least 75% of your supply.

• More helpful information in the National Health Law Program’s blog post: “People on Medi-Cal Can Access Behavioral Health Services During the COVID-19 Pandemic through Telehealth and Relaxed Prescribing Practices.“

For more information about Medi-Cal’s several mental health and substance use programs, visit the state’s COVID-19 Response Behavioral Health website.

How can I access other health benefits like CBAS, IHSS & Regional Center services?

Community-Based Adult Services (CBAS), formerly known as Adult Day Health Care (ADHC), is still a Medi-Cal benefit during the pandemic. CBAS centers might suspend activities and services at their facilities, but they can still provide them in your home or by phone/video.

You can still get In-Home Supportive Services (IHSS) during the pandemic. For the latest on how to find an emergency back-up provider, get IHSS without a face-to-face interview, and stay safe with your provider, visit Disability Rights California’s “Coronavirus (COVID-19) Rights of People Who Get IHSS and Caregivers” website.

For information on accessing Regional Center services, visit Disability Rights California’s “Coronavirus (COVID-19) Regional Center Clients” website.

Watch out for coronavirus treatment scams!

Patients should be wary of any offers of coronavirus “cures” or “treatments” such as “teas, essential oils, and colloidal silver.” Federal authorities have identified several companies accused of scamming patients. You should also watch out for people and companies charging for coronavirus (COVID-19) tests. Those are likely scams. For more information, visit the Federal Trade Commission’s Coronavirus Scams website.

Where can I get help with my health insurance and coronavirus?

Not sure if your health plan has to follow these rules? Having trouble getting what you need from your health plan? Need your county to process your Medi-Cal application or renewal faster or better? For help, please call the Health Consumer Alliance at 888‑804‑3536 for a free, confidential consultation and information. TTY 877‑735‑2929.

What if coronavirus is causing problems with my job?

Find answers to many questions about your rights as a worker in these frequently asked questions from Legal Aid at Work, including:

• My employer closed my workplace temporarily because of the coronavirus and is forcing employees to take unpaid leave. What can I do?
• I have coronavirus and am not currently able to work because of my illness. What can I do to receive income while I’m not working?

You can also learn more about disability insurance, paid family leave, and unemployment insurance here. The California Labor Federation has Coronavirus 2019 (COVID-19) Resources for Workers.