FOR INSURED INDIVIDUALS
Inspire Diagnostics is providing COVID-19 testing with no out-of-pocket cost to the individual.  (Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered). The Federal Cares Act is no longer covering the cost of COVID-19 testing and vaccination for the uninsured.  However, under the Cares Act, all private, Medicare and Medi-Caid plans are required to cover COVID-19 testing with “no pocket of pocket” costs to their members. We accept the reimbursed amount from the insurance company.  There is no amount owed by you to Inspire Diagnostics.  If your school district has prearranged with Inspire Diagnostics to cover the cost of testing, Inspire will not be billing individual insurance.

Insurance companies commonly send an Explanation of Benefits (EOB) to their insured members showing the amount of benefit paid under their plan. Healthcare providers, including Inspire Diagnostics, submit claims at standard rates. Often, insurance companies reimburse at significant lower amounts.  An EOB may show the difference between the standard charge and actual reimbursed amount as an adjustment or patient responsibility.  An EOB, however, is not an invoice.

WHY DID I RECEIVE A CHECK FROM MY INSURANCE?
Certain plans reimburse the insured member instead of the healthcare provider. This occurs mostly in cases in which the healthcare provider is out of network with that plan. In these cases, we would ask that, if you receive payment from your plan, please deposit the check and send the same amount to Inspire Diagnostics. Please note the name of the person so that we can ensure the payment is applied to the proper claim.

We recommend that the insured member of an out of network health plan contact the member services and request that the reimbursement payments are routed directly to Inspire.

FOR UN-INSURED INDIVIDUALS (CALIFORNIA RESIDENTS ONLY)
In the case of an uninsured or underinsured California resident, there is no out-of-pocket cost for testing. (Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered). The state of California has a state benefit program in place called the COVID-19 Uninsured Group Program funded by the CA Department of Health Care Services (DHCS).

The COVID-19 Uninsured Group program was implemented by the Department of Health Care Services (DHCS) on August 28, 2020, and covers COVID-19 diagnostic testing, testing-related services, and treatment services, including vaccination, hospitalization and all medically necessary care, at no cost to the individual.  The COVID-19 Uninsured Group enrollment period begins on the date of application and ends on the last calendar day of the 12th month from the date of the COVID-19 Uninsured Group application in which the individual was determined eligible for the COVID-19 Uninsured Group or when the Public Health Emergency ends, whichever is sooner.

Inspire accepts the CA Department of Health Care Services COVID-19 Uninsured Group Program application as payment for our services until it expires. Please see an onsite technician to complete an application for the Uninsured Group Program.  The application is also available below.  The only requirement to qualify for this program is that you are a CA resident.  This benefit is regardless of immigration status and no state or government issued ID is required.

English application:
https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/COVID-19UninsuredGroupProgram/MC-374-ENG-09-2020.pdf

Spanish application:
https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/COVID-19UninsuredGroupProgram/MC-374-SPA-0920.pdf

**Required field:  #1-15 and answer #18-19 and for some #20. (Social Security number, government or state issue ID are not required field to complete)

Email all completed applications (Screenshot of the application emailed is acceptable) on the same day to: insuranceupdate@inspirediagnostics.com

Email schools@inspirediagnostics.com for any questions.