New Mexico is among the ten states with the highest increase in unemployment due to the COVID-19 pandemic, meaning many people have lost health insurance coverage as well. The state says no one should have to pay for testing and treatment related to the coronavirus, but some people are still being charged for that care. KUNM’s Khalil Ekulona spoke with New Mexico Superintendent of Insurance Russell Toal about how the state is trying to help.
RUSSELL TOAL: We have regulatory authority over, you know, essentially, private insurance. So our order on the free testing and treatment applied to people who were covered by that. Now, since that time, under both federal law and state action, no one should be charged for COVID-19 testing. Period. Insured, or uninsured. Now, it is true, if somebody works for an employer, and they have a business health plan, they could be charged for receipt of services. But even there, they should not be charged at all for testing. We set up a call line for people if they have any questions, or they're having any problems or they're inappropriately getting charged. They can call us at 833-415-0566 and we'll help handle their problem.
KUNM: Now, what about for people who get hit with surprise bills? Do you offer help to them as well?
TOAL: We do. We also issued orders saying that they should not be hit with these surprise bills. And we told the insurance companies that they have to cover what are known as ‘out of network’ services in the same way that we cover ‘in network’ services. Because, as you know, there's a whole new triage system during this pandemic, and patients don't always have the choice of where to go.
KUNM: Now, I want to ask you this question, because we have a guest that got a COVID-19 test through UNMH, but then they were hit with a surprise bill. The hospital seems to be trying to make it so that those bills aren't the full $1,500. But the people we spoke with say that they're still expected to pay something. This seems out of line with the order that your office implemented, or is it a different case?
TOAL: I don't know the details of those charges. But on the surface it does seem out of line. We've had a discussion with UNM hospital, we can get some more detail from someone, we'd be happy to follow up with them.
KUNM: Okay. We'll look to try to get that detail to you. Now, what about people who don't have any health coverage, or who are on Medicare or Medicaid?
TOAL: Medicaid and Medicare are both covering the cost of testing and of services. And in the case of Medicaid, there's no cost sharing at all. Folks who have Medicaid coverage should be able to get whatever they need without out of pocket costs. On Medicare, the testing is going to be free. But if they go to a hospital, there are some charges. And if people don't have any insurance right now, they still can get the testing for free, and that's really important. If they need to get insurance, they should first apply for Medicaid. And if that doesn't work for any reason – their income might be too high, then they need to look at the state's health insurance, exchange or marketplace. It's called beWellNM and they can apply online for health insurance coverage there. If neither of those two work, we have a New Mexico medical insurance pool, sometimes known as the high risk pool. If you're uninsured, you can apply for coverage there too.
KUNM: Okay, talk to me about why this is important for the state that people find coverage.
TOAL: Well, because we don't want people postponing the care that they need. If they have underlying conditions, it makes them more at risk. So, they need to get those underlying conditions treated as soon as they can. And frankly, if we're trying to combat community spread, giving people access to health insurance and health care coverage is one of the best things we can do besides all the stay-safe measures.
This is an excerpt from an interview that originally aired on our daily show Your NM Government. Catch it every Wednesday through Friday at 7:30 p.m. here on KUNM, or subscribe to it wherever you get your podcasts.
Your NM Government is a collaboration between KUNM, New Mexico PBS and the Santa Fe Reporter.
KUNM reporter Bryce Dix edited this interview.