Care for COVID-19 Act

To require private health insurers to cover care related to COVID–19 without cost-sharing and to provide for special enrollment periods for individuals diagnosed with COVID–19. 1. Short title This Act may be cited as the Care for COVID–19 Act 2. Coverage of services related to COVID–19 (a) In general Title XXVII of the Public Health Service Act is amended by inserting after section 2719A ( 42 U.S.C. 300gg–19a 2720. Coverage of services related to COVID–19 A group health plan, and a health insurance issuer offering group or individual health insurance coverage, shall provide coverage for and shall not impose any cost-sharing requirements for outpatient and inpatient services related to the diagnosis, care, and treatment of COVID–19, including— (1) diagnostic services related to COVID–19; (2) supportive care for COVID–19; (3) vaccines for the prevention of COVID–19; (4) treatment services, including prescription drugs and medical devices, for the treatment of COVID–19 and of complications related to COVID–19; (5) inpatient and outpatient physician and hospital services related to COVID–19; and (6) any other service the Secretary determines appropriate. . (b) Application The amendment made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2020. 3. Special enrollment period (a) Public health service act Section 2702(b)(2) of the Public Health Service Act ( 42 U.S.C. 300gg–1(b)(2) , including a special enrollment period for individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19, beginning on the date on which the diagnosis or presumptive positive diagnosis is reported to the health insurance issuer (b) Patient protection and affordable care act Section 1311(c)(6) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(6) (1) in subparagraph (C), by striking and (2) by redesignating subparagraph (D) as subparagraph (E); and (3) by inserting after subparagraph (C) the following new subparagraph: (D) a special enrollment period for individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19, beginning on the date on which the diagnosis or presumptive positive diagnosis is reported to the Exchange; and . (c) Special enrollment periods Section 9801(f) 26 U.S.C. 9801(f) (4) For individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19 (A) In general A group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan upon a diagnosis or a presumptive positive diagnosis of COVID–19, with the special enrollment period beginning on the date on which the diagnosis or presumptive positive diagnosis is reported to the group health plan. (B) Enrollment period The Secretary shall promulgate regulations with respect to the special enrollment period under subparagraph (A), including establishing a time period for individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19 to enroll in coverage or change coverage, and effective date of such coverage. . (d) ERISA Section 701(f) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1181(f) (4) For individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19 (A) In general A group health plan or health insurance issuer in connection with a group health plan shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan upon a diagnosis or presumptive positive diagnosis of COVID–19, with the special enrollment period beginning on the date on which the diagnosis or presumptive positive diagnosis is reported to the group health plan or health insurance issuer or the diagnosis or presumptive positive diagnosis is confirmed by a health care provider. (B) Enrollment period The Secretary shall promulgate regulations with respect to the special enrollment period under subparagraph (A), including establishing a time period for individuals who are diagnosed with or have a presumptive positive diagnosis of COVID–19 to enroll in coverage and effective date of such coverage. .

Summary: Care for COVID–19 Act This bill requires private health insurance plans to cover, without any cost-sharing requirement, inpatient and outpatient services related to the diagnosis, care, and treatment of COVID-19 (i.e., coronavirus disease 2019). The bill further provides a special enrollment period for individuals who are diagnosed with, or presumed diagnosed with, COVID-19 to obtain coverage through (1) the individual or group marketplace, (2) a health insurance exchange, or (3) an employer-funded health plan.