DMHC COVID-19 Response

The DMHC has taken several actions in response to the COVID-19 pandemic to protect consumers’ health care rights and ensure a stable health care delivery system. The resources below provide information about health plan requirements to cover COVID-19 health care services, and DMHC guidance to health plans.

DMHC Fact Sheets

Learn more about health care coverage options and health plan member rights for COVID-19 health care services.

Graphic of a clock
Coverage Options Fact Sheet

Graphic of a COVID-19 test, vaccine and a bottle with pills
Know Your Health Care Rights
Fact Sheet on COVID-19 Testing, Vaccine & Treatment
(Pruebas, vacunas y tratamiento del COVID-19)

Additional State Resources

California Department of Public Health (CDPH) COVID-19 Resources

Department of Health Care Services (DHCS) COVID 19 Resources

DMHC COVID-19 Actions

The Department took several actions to expand access to health care during the COVID-19 emergency, such as creating and extending special enrollment periods for uninsured Californians to gain health care coverage, directing health plans to cover vaccines and testing, expanding the coverage of telehealth services, and supporting hospitals and other parts of the health care delivery system.

The resources below provide more information about the Department’s actions and guidance to health plans during the unprecedented events brought on by the pandemic.

Access to Health Care Services

At the start of the pandemic in 2020, the DMHC took actions to require health plans to offer a special enrollment period to make sure Californians had an available path to affordable health care coverage.

APL 21-008 - Special Enrollment Period; Coverage Effective Dates (1/28/2021)

Press Release - California Joins President Biden in Responding to COVID-19 Pandemic by Announcing Special Enrollment to Help People Get Insurance (1/28/2021)

APL 20-029 - Extension of Special Enrollment Period to August 31, 2020 (7/31/2020)

Press Release - California to Give Consumers More Time to Sign Up for Health Care Coverage by Extending Special Enrollment Deadline During COVID-19 Pandemic (7/29/2020)

APL 20-023 - Extension of Special Enrollment Period in APL 20-010 (6/23/2020)

Press Release - California Extends Special-Enrollment Deadline to Give Consumers More Time to Sign Up for Health Care Coverage During COVID-19 Pandemic (6/23/2020)

APL 20-010 - Special Enrollment Period and Coverage Effective Dates (3/21/2020)

Press Release - California Responds to COVID-19 Emergency by Providing Path to Coverage for Millions of Californians (3/20/2020)

COVID-19 Testing, Vaccination, and Treatment

The Department took actions to ensure health plans provided access to COVID-19 testing, vaccines and treatment.

APL 24-015 - High Deductible Health Plan Products and Coverage of COVID-19 Testing (7/22/2024)

APL 23-021 - Payment of COVID Claims for COVID-19 Tests Delivered between March 4, 2020 and December 31, 2021 (11/14/2023)

APL 23-017 - Impact of the end of federal Public Health Emergency on health plan coverage of COVID-19 tests, immunizations, and therapeutics (7/21/2023)

APL 22-032 - Compliance with Senate Bill 1473 (2022) (12/27/2022)

APL 22-017 - Coverage of COVID-19 Therapeutics (6/14/2022)

APL 22-014 - Senate Bill 510 COVID-19 Testing and Vaccination Coverage Guidance (4/25/2022)

APL 22-005 - Federal Requirement to Cover At-Home COVID-19 Tests Purchased Over-the-Counter (1/25/2022)

APL 21-023 - Flu Vaccines; Preparation for COVID-19 Vaccines (11/1/2021)

APL 21-020 - Continued Coverage of COVID-19 Diagnostic Testing (7/26/2021)

APL 21-016 - Continued Coverage of COVID-19 Diagnostic Testing (6/7/2021)

APL 21-014 - COVID-19 Vaccinations for Homebound Enrollees; Transportation Assistance to Obtain COVID-19 Vaccines (5/3/2021)

APL 21-012 - COVID-19 Vaccine Prioritization for Individuals with High-Risk Health Conditions (3/12/2021)

APL 21-011 - New Federal Guidance Regarding COVID-19 Testing (3/10/2021)

APL 20-039 - COVID-19 Vaccine Coverage (12/11/2020)

Press Release - DMHC Reminds Californians Approved COVID-19 Vaccines Will Be Provided at No Cost (12/11/2020)

APL 20-037 - Vaccinations; Coverage and Flexibility (10/14/2020)

APL 20-034 - Updated COVID-19 Screening and Testing (9/23/2020)

APL 20-033 - Implementation of Emergency Regulation Regarding COVID-19 Diagnostic Testing (9/18/2020)

APL 20-028 - Emergency Regulation Regarding COVID-19 Diagnostic Testing (7/23/2020)

APL 20-006 - COVID-19 Screening and Testing (3/5/2020)

Press Release - Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing (3/5/2020)

The Department worked with state leaders and hospitals to maximize patient capacity by allowing for expeditious transfers from the most highly impacted hospitals to hospitals with more available capacity.

APL 21-021 - Transfer of Hospitalized Enrollees per Regulation Section 1300.67.02 (8/17/2021)

APL 21-004 - Transfer of Unstable or Destabilized Enrollees (1/6/2021)

APL 21-003 - Transfer of Enrollees Per State Public Health Officer Order (1/6/2021)

APL 20-040 - Network Stability - REVISED (1/28/2021)

APL 20-040 - Network Stability (12/14/2020)

The Department also provided guidance to health plans to mitigate negative health outcomes, and ensure vulnerable populations received care and support during the COVID-19 emergency.

APL 20-016 - Preventing Isolation and Supporting Older and other At-Risk Individuals to Stay Home and Stay Healthy During COVID-19 Efforts (4/15/2020)

APL 20-014 - Mitigating Negative Health Outcomes due to COVID-19 (4/7/2020)

APL 20-012 - Health Plan Actions to Reach Vulnerable Populations (3/27/2020)

Expansion of Telehealth Services

The DMHC issued guidance ensuring health plans provided continued and safe access to care for health plan members through telehealth, and requiring plans to reimburse providers for telehealth services at the same rate as if the services were delivered in person.

APL 20-032 - Continuation of DMHC's All Plan Letters Regarding Telehealth (9/4/2020)

APL 20-013 - Delivery of Telehealth Services and Billing for Telehealth Services (4/7/2020)

DMHC FAQ - Telehealth During the COVID-19 State of Emergency (4/7/2020)

APL 20-009 - Reimbursement for Telehealth Services (3/18/2020)

APL 20-007 - “Social Distancing” Measures in Response to COVID-19 (3/12/2020)

Support to Hospitals and the Health Care Delivery System

The DMHC directed health plans to take steps to ensure continued network adequacy and to reduce unnecessary barriers to the efficient admission, transfer and/or discharge of health plan members.

APL 21-009 - Dental Plan Reporting Regarding Network Stability - REVISED (2/16/2021)

APL 21-006 - Dental Plan Reporting Regarding Network Stability (1/26/2021) SUPERSEDED BY APL 21-009

APL 20-020 - Network Adequacy and Unnecessary Burdens on Providers (5/20/2020)

APL 20-008 - Provision of Health Care Services During Self Isolation Orders (3/18/2020)

APL 20-042 - Removal of Administrative Burdens on Hospitals (12/16/2020)

Press Release - DMHC Directs Health Plans to Remove Administrative Burdens on Hospitals During COVID-19 Surge (12/16/2020)

The Department also enacted new reporting requirements for health plans to ensure plans are sufficiently supporting providers to acquire COVID-19 supplies, such as Personal Protective Equipment (PPE), to safely deliver services to plan members.

APL 21-007 - Dental Plan Reporting Regarding PPE and Related Support to Providers (1/26/2021)

APL 20-043 - Health Plan Reporting Regarding PPE and Related Support to Providers (12/16/2020)

Additionally, the Department temporarily extended select filing deadlines and requirements to give health plans additional time to comply during the COVID-19 emergency.

APL 23-013 - Large Group Coverage of Association Health Plans: Extension of Phase Out and Guidance (4/20/2023)

APL 21-022 - Hospital Surges; Continued Applicability of DMHC COVID-19 Requirements and Guidance (10/26/2021)

APL 20-031 - Association Health Plans Extension of Phase-Out Period (8/21/2020)

APL 20-019 - Association Health Plans Extension of "Phase-Out" Period (5/5/2020)

APL 20-018 - Modification of Timely Access PAAS Timeframes (4/29/2020)

APL 20-017 - General Licensure Regulation: Extension of Phase-In Period for Expedited Exemption Requests (4/16/2020)

APL 20-015 - COVID-19 Temporary Extension of Plan Deadlines (4/13/2020)