North Dakota Insurance Commissioner Addresses COVID-19 Testing Coverage

North Dakota Insurance Commissioner Jon Godfread has issued a bulletin addressing coverage for COVID-19 testing in response to an executive order from Gov. Doug Burgum. The new bulletin builds an a previous bulletin in which health carriers and travel insurers were asked to identify and remove barriers to testing and treatment for COVID-19.

The latest bulletin encourages insurance carriers to continue doing their part by covering the expense of medically necessary testing for insured individuals. Health insurance will continue to support medically necessary treatments and testing, however health insurance should not be expected to cover public health surveillance or employment screening programs, according to Godfread.

At present, the Insurance Department is aware of three types of COVID-19 tests:

• Polymerase Chain Reaction (PCR) tests look for the presence of the unique DNA of COVID-19 in a patient.
• Antigen tests look for a unique part of COVID-19, such as a specific protein on one of the unique COVID-19 spikes.
• Antibody tests (also known as serology tests) look for the presence of antibodies in a patient’s immune system that may fight off COVID-19.

The bulletin places the expectation that carriers cover PCR and antigen tests designed to detect the presence of COVID-19 when a patient’s symptoms indicate the medical need to conduct a test.

In addition, the insurance department expects carriers to cover antibody tests only when such tests are medically necessary in order to support diagnosis or treatment for COVID-19 or for treatment of another disease when information about COVID- 19 antibodies may impact the future outcome of that treatment for an individual. It was further clarified that public health surveillance testing or employee screening are not considered to medically necessary.

Topics COVID-19