COVID-19 testing and vaccinations

Understanding the changes that come with the end of the Public Health Emergency

The Public Health Emergency (PHE) for COVID-19 expired on May 11, 2023. The PHE allowed patients and healthcare providers to access COVID-19 vaccinations, testing, treatments, and services more easily during the pandemic. The end of the PHE will have changes that affect some healthcare costs and access to services. Here is a quick guide to what will, won’t, or could be changing now that the PHE has expired.

What WILL be affected:

Certain Medicare and Medicaid waivers

  • During the COVID-19 PHE, a combination of emergency authority waivers, regulations, and regulatory guidance were used to expand access to care and to give health care providers the flexibilities needed to help keep people safe.
  • Many of these waivers and flexibilities were necessary to expand hospital capacity to care for higher numbers of patients needing care during the pandemic.
  • No longer necessary, many waivers related to increasing care capacity will end when the PHE expires.

3-Day Skilled Nursing Facility (SNF) waiver

  • During the pandemic, Medicare temporarily waived the requirement for a 3-day prior hospitalization before covering the cost for a skilled nursing facility (SNF)
  • After May 11, patients who get referred to a SNF without 3 days in the hospital will either be denied admission to the SNF or may be surprised by an unexpected bill when Medicare won’t cover it.
  • WellSpan has worked with our SNF Preferred Provider Network and independent practice partners to ensure awareness of the change regarding 3-day requirements for a covered admission.

Coverage for COVID-19 testing

  • Medicare
    • Medicare Part B beneficiaries will continue to have coverage without cost sharing for laboratory-conducted COVID-19 tests when ordered by a provider.
    • Access to free over-the-counter (OTC) COVID-19 tests will end though, consistent with the statute on Medicare payment for OTC tests set by U.S. Congress.
  • State Medicaid
    • State Medicaid programs must provide coverage without cost sharing for COVID-19 testing until September 30, 2024.
  • Private Insurance
    • Private insurance companies are not required to cover tests without cost sharing for OTC or laboratory tests.
    • However, coverage may continue if plans choose to continue to include it. If you are unsure if you have coverage for COVID-19 testing, please reach out to your insurance company.

Reporting of COVID-19 laboratory results and immunization data

  • COVID-19 testing data reporting will not be required from labs.
  • The CDC will stop producing the color-coded Community Level reports and maps of transmission rates.


What WON’T be affected:

Access to COVID-19 vaccinations and certain COVID-19 treatments

  • Access to COVID-19 vaccinations and certain COVID-19 treatments will generally not be affected.
  • The FDA’s Emergency Use Authorizations for COVID-19 products (including tests, vaccines, and treatments) will not be affected.

Out-of-pocket expenses for COVID-19 vaccinations

  • Out-of-pocket expenses for COVID-19 vaccinations will not be affected for most patients.
  • Most patients will continue to pay nothing out-of-pocket for the COVID-19 vaccine. Most private insurance plans will continue to fully cover vaccines without a co-pay as a preventive health service.
  • COVID-19 vaccinations are covered under Medicare Part B without cost sharing, and this will continue.
  • Medicaid will continue to cover all COVID-19 vaccinations without a co-pay or cost sharing through September 30, 2024.

Telehealth (video visits) through Medicare

  • Individuals with Medicare can continue to see providers virtually using telehealth.
  • Coverage for most Medicare telehealth services will remain in place through December 2024.

Telehealth (video visits) through Medicaid

  • Individuals with Medicaid can continue to see providers virtually using telehealth.
  • States already had significant flexibility with respect to covering and paying for Medicaid services delivered via telehealth prior to the COVID-19 PHE and will continue to be available after the COVID-19 PHE ends.


What MAY be affected:

Out-of-pocket expenses for certain COVID-19 treatments

  • Out-of-pocket expenses for certain COVID-19 treatments may change, depending on an individual’s insurance coverage.
  • Changes would be similar to costs that one may experience for other drugs. Talk with your pharmacy for exact out-of-pocket expenses associated with COVID-19 treatments (i.e. Paxlovid).

Telehealth (video visits) prescribing of controlled substances

  • On May 3, the Drug Enforcement Administration (DEA) announced a temporary extension of PHE flexibilities allowing providers to prescribe controlled substances via telehealth until further notice.
  • This allowed for some prescribing of controlled substances, such as buprenorphine, to patients without an in-person interaction.
  • While this has been extended, the prescription of controlled substances via telehealth may change. Please continue to check back as any new rules are announced.

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