The federal government plans to end its COVID-19 emergency in May, which means a wave of changes are on the horizon.

Under the emergency declaration, people were given access to free COVID-19 tests, vaccines and treatments. Once it expires May 11, everyone, including those with health insurance, should expect some out-of-pocket costs for testing and treatments. While vaccines will likely stay free for those with insurance, those without insurance will have to pay if they want a shot.

Here’s a breakdown of what to expect:

WILL INSURANCE STILL COVER COVID TESTS? WHAT ABOUT AT-HOME TESTS?

Currently, private insurance companies and Medicare cover most COVID-19 tests and are required to cover up to eight at-home test kits per month. Medicaid, the federal and state health insurance program for low-income families, also provides COVID testing coverage.

Once the federal emergency ends in May, insurers will no longer be required to cover at-home tests or PCR tests, according to Dr. Jose Figueroa, an assistant professor of Health Policy and Management at Harvard T.H. Chan School of Public Health.

This means the next time you get tested for COVID, you may have to pay an out-of-pocket expense. Some insurers might decide to cover part or all of the testing costs. They could also add restrictions, such as covering PCR tests only done with in-network providers or tests ordered by a physician. Figueroa said Medicaid beneficiaries are expected to have some testing coverage into 2024. For people without insurance, expect to pay a hefty bill. COVID-19 tests that go to labs often cost more than $100. At-home COVID test prices vary.

Almost a million Floridians could lose their Medicaid coverage starting in April once the federal moratorium ends that prevented states from kicking people off Medicaid during the pandemic. More than 5.6 million Floridians receive Medicaid, or about one-fourth of the state’s population. Of those, nearly 1.8 million Floridians enrolled in Medicaid during the pandemic, when the federal government paid states extra money so they would not remove people from Medicaid even if they were no longer eligible to get the federal-state health insurance for low-income families. Florida is one of 11 states that did not expand Medicaid through the Affordable Care Act, leading hundreds of thousands of Florida families to fall into the Medicaid coverage gap.

WILL YOU HAVE TO PAY FOR COVID VACCINES AND TREATMENTS LIKE PAXLOVID?

COVID-19 vaccines and boosters are currently free for everyone. The Kaiser Family Foundation expects most people with private health insurance, Medicare and Medicaid will continue to have the shots covered after May 11. While the vaccines will likely continue to be available after May 11 at retail pharmacies like CVS, Walgreens, Winn-Dixie, Publix, Fresco y Más, and Walmart, some insurers might require you to get the shot at an in-network provider.

For people without insurance, you’ll have to pay for the vaccines and boosters once the federally purchased supply of shots dries up, said Figueroa. And it could get expensive. Both Pfizer and Moderna are considering charging $110 to $130 a dose once the vaccines enter the commercial market. For people without insurance or who are underinsured, your most affordable option would likely be to visit clinics or community health centers that provide services and vaccines on a sliding fee scale. For uninsured children, COVID vaccines will be available for free through the Vaccines for Children Program, though families might be charged an administrative fee, according to Kaiser.

In terms of treatments like Paxlovid, an oral antiviral medication people can get by prescription to treat COVID, the federal government has been paying the tab. Once the federal supply runs out, people should expect to pay some out-of-pocket costs. Insurers might opt to cover some, or all of the cost, though those without insurance will have to pay the full price for the pills, according to Figueroa. It’s also possible people might see their insurance premiums go up to cover the costs of testing, vaccines and treatments.

WILL COVID TEST SITES IN MIAMI-DADE BE AFFECTED?

COVID-19 test and vaccines will continue to be free at Nomi Health-operated sites across Miami-Dade County, including at Tropical Park, Zoo Miami and Miami Dade College North campus, at least until the federal emergency ends on May 11. It’s still too soon to say what will happen after. Nomi Health, in an email, said it is monitoring the situation and remains committed to ensuring everyone has “access to safe and effective vaccines and testing.” “We will make the required adjustments to our services and sites based on the latest guidance and recommendations from health experts and our permits and agreements with authorities,” Nomi Health said.