Will my health insurance cover the costs of coronavirus testing and treatment?

Will my health insurance cover the costs of coronavirus testing and treatment?

In general, comprehensive major medical health plans will cover COVID-19 treatment and lab-based testing the same way they’ll cover treatment and testing for any other illness. So the plan's regular cost-sharing (deductible, copays, coinsurance) will apply.

During the COVID public health emergency, most plans were required to cover the full cost of testing, including lab-based and at-home testing. But that's no longer the case. So coverage of at-home COVID tests is now optional for health plans.

How will my health plan cover a COVID-19 vaccine?

Under the ACA’s preventive care rules, any vaccine recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) must be fully covered by all non-grandfathered health plans.¹ Since COVID-19 vaccines were consistently recommended by ACIP from 2020 through 2024, this coverage requirement continued even after the COVID public health emergency ended.

However, ACIP’s September 2025 recommendation calls for “shared clinical decision-making,” meaning that the recommendation is for patients to discuss the issue with their medical provider before obtaining a COVID-19 vaccine.². HHS clarifies that this “allows for immunization coverage” under health insurance. But the recommendation includes an additional layer of complexity, since health plans could require patients to meet with their health provider before the plan will cover a COVID-19 vaccine. As a result, KFF notes that “some consumers may face challenges” with vaccine coverage.³

As of September 2025, 13 states had implemented rules to require state-regulated (non-self-insured) plans to cover COVID-19 vaccines without cost-sharing.³ And AHIP, the trade association that represents health plans, noted in mid-September that health plans will continue to cover updated COVID-19 vaccines without cost-sharing, through at least the end of 2026.⁴

Learn more about 2025-2026 COVID-19 vaccine access and coverage.

How can the uninsured get COVID-19 testing and vaccines?

HHS has a resource page about COVID-related care for people who don't have health insurance. It includes details about obtaining zero-cost vaccines, and low-cost or zero-cost testing.

It is unclear whether the federal government will continue to support widespread access to COVID-19 vaccines under the Trump administration and HHS Secretary RFK Jr.⁵ But depending on the state where a person lives, the state health department (find yours here) could still be a good resource for uninsured people to access COVID testing and vaccines.

How much of COVID treatment costs will health plans cover?

This depends on the details of the specific plan. Comprehensive major medical plans will generally cover all medically necessary inpatient and outpatient care that someone receives for COVID (or long COVID), just as they would for any other illness. But "cover" doesn't mean they'll pay for all of it.

This is where patients’ cost-sharing comes into play. Under the ACA, all non-grandfathered, non-grandmothered health plans must have in-network out-of-pocket maximums that don’t exceed $9,200 for a single individual in 2025, or $10,600 in 2026.⁶ (This limit doesn’t apply to plans that aren’t regulated by the ACA, such as short-term health plans.)

So for most patients who need COVID treatment in 2026 and who have comprehensive major medical coverage, out-of-pocket costs won’t exceed $10,600 as long as they stay in-network. But that’s still a huge amount of money, and most people don’t have it sitting around. Many health plans have out-of-pocket limits well below that amount, but most people are still going to be on the hook for a four-figure bill if they end up needing to be hospitalized for COVID-19. Although employer-sponsored plans tend to be more generous than the plans people buy in the individual market, the average employer-sponsored plan still had an out-of-pocket maximum of $4,409 for a single employee in 2024.⁷

If you have a health savings account (HSA), you can use the tax-free money in your account to pay for COVID treatment costs. And if your employer offers a flexible spending account (FSA) and you've opted to contribute to it, that can also be used for out-of-pocket COVID treatment expenses.

How do I make sure I have coverage for COVID-related costs?

Here are a few pointers:

• If you’re uninsured , you can enroll in a plan through the health insurance Marketplace (exchange) in your state during open enrollment, which runs from November 1 to January 15 in most states (this window will become shorter starting in the fall of 2026). You can also enroll if you have a qualifying life event that triggers a special enrollment period.
• Enrolling in coverage through the exchange will give you access to income-based subsidies that could make your coverage more affordable than you might expect.
• If your income is low (even temporarily, due to a layoff), check to see if you might be eligible for Medicaid.
• If you have health insurance, make sure you understand what your plan covers and what your cost-sharing responsibilities are for various outpatient and inpatient care.
• Check to see how your health plan handles prior authorizations.
• Pay attention to the details of your health plan’s provider network. Your best chance of avoiding balance billing is to make sure you see in-network providers, and you don’t want to be having to sort that out while you or a family member is very unwell.
• Check with your plan to see how telehealth is covered and be sure you understand how to use the telehealth services.
• If you have an HSA-qualified health plan, try to make contributions to your HSA. Whatever money you contribute to your HSA will be available to withdraw tax-free if you end up needing it to pay out-of-pocket costs for medical care.