Based on current COVID-19 trends the Department of Health and Human Services (HHS) is planning to end the federal Public Health Emergency (PHE) on May 11, 2023.
What HHS says won’t change:
- COVID-19 vaccines and treatments will still be widely accessible to all who need them, and many Americans will continue to pay nothing out-of-pocket for the COVID-19 vaccine. (see below for more details on who will continue to have COVID-19 vaccine coverage)
- Major telehealth flexibilities will continue to exist for those participating in Medicare or Medicaid;
- Access to COVID-19 vaccinations and certain treatments, such as Paxlovid and Lagevrio, will generally not be affected
What will change when the PHE ends on May 11?
COVID-19 Vaccine Coverage
- Most private insurance plans fully cover vaccines, and will continue to cover COVID-19 vaccines.
- Medicare Part B will continue to cover COVID-19 vaccines without cost sharing.
- Medicaid will continue to cover all COVID-19 vaccinations without a co-pay or cost sharing through September 24, 2024.
COVID-19 Treatment Coverage
- For private insurance plans, the out-of-pocket cost of certain COVID-19 treatments will depend on your coverage. The cost will be similar to the cost of other drugs through your private insurance plan.
- Medicaid programs will continue to cover COVID-19 treatments without cost sharing through September 24, 2024.
COVID-19 Testing Coverage
- Medicare Part B enrollees will continue to have coverage without cost sharing for lab-conducted COVID-19 tests when ordered by a provider. Access to free over-the-counter COVID-19 tests will end.
- Private insurance companies will no longer be required cover COVID-19 lab tests or over-the-counter tests. Coverage may continue if plans choose to include it.
- Medicaid will continue to provide coverage for COVID-19 testing without cost sharing until September 30, 2024. After this date, coverage will vary by state.
Medicaid Continuous Coverage
During the COVID-19 PHE Medicaid has been required to keep people continuously enrolled, and they have not been able to kick people off who no longer meet eligibility requirements. This will change before the PHE ends.
States will begin to terminate Medicaid enrollment of individuals who no longer meet Medicaid eligibility requirements on or after April 1, 2023. After this date, states will have up to 12 months to return to normal eligibility and enrollment operations.
Changes to SNAP Benefit Amounts
The temporary boost to SNAP benefits put in place during the COVID-19 pandemic, known as emergency allotments, will end nationwide after the February 2023 issuance. As of March 1, SNAP benefits will return to pre-pandemic levels.
Medicare & Medicaid Telehealth Coverage
- Major Medicare telehealth flexibilities will not be affected. The current flexibilities will remain in place through December 2024.
- Medicaid telehealth flexibilities will also not be affected.
Emergency Use Authorizations (EUAs)
These will not change. The emergency use authorization of COVID-19 products, including tests, vaccines, and treatments will remain in effect.
Opioid Treatment Programs
- Access to buprenorphine for opioid use disorder treatment in Opioid Treatment Programs will not be affected.
- Methadone take-home doses for opioid use disorder treatment will not be affected.