Even though the federal government mandated that testing for COVID-19 is free for all Americans, some people have still been faced with expensive emergency room and hospital bills for seeking tests or treatment. Others have had to fight with their insurance companies to get the cost covered.
What will you face if you decide to get tested for the novel? Turns out, the answer depends on where you get tested and whether or not you need treatment after your diagnosis.
How much does the coronavirus test cost?
The Families First Coronavirus Response Act mandates that COVID-19 tests and care related to the diagnosis of COVID-19 must be free for anyone, insured or not. That means that if you visit the doctor to get tested for COVID-19, the cost of both the visit and the test are covered.
However, if you require any care or treatment beyond the diagnosis, you or your insurance will likely be billed for those costs.
Dafna Michaelson Jenet, a Colorado state representative, tells CNET that her health insurance with United Healthcare covered the full cost of the coronavirus test. Her insurance did not, however, cover the cost of her stay in the emergency room — which was necessary because she says she was very sick at the time.
After being tested and diagnosed, Jenet was on the hook for an ER bill of more than $1,000.
Even though coronavirus tests are supposed to be free, some hospitals or clinics might charge you the cost of your copay until they bill your insurance and know for sure that your test is covered. Anshel Sag, an analyst at Moor Insights & Strategy, has one such story:
"Initially, the hospital charged me my $150 copay even though they knew that the whole thing should be covered as stated by the [San Diego] county health order," Sag tells CNET. "I had to battle with my insurance company for them to understand that their own website says they'll cover it without any copay."
Eventually, Sag says his insurance company, Sharp Health Plan, worked it out with the hospital — which had sent him a second bill for the copay in the meantime. Sag, who ended up staying in the hospital for nine days, says he's dreading the "big bill" for his care and is hoping his insurance covers it all.
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The moral of the story is that yes, coronavirus tests should be free, but that doesn't mean you won't front any costs, and you might have to put up a fight against your insurance company.
Some large insurance companies have stated they'll cover some of the out-of-pocket costs that come along with care for COVID-19, Aetna, Cigna, Humana and Kaiser Permanente included. Unless you're having an emergency and need testing or care right away, it's worth calling your insurance company and asking what they'll cover and what they won't in regard to COVID-19.
Where to get tested for coronavirus and what you pay
With the larger rollout of coronavirus tests, there are now more places to get tested. However, because tests remain limited, you typically need a doctor's order to get tested. Some places also require you to make an appointment, so don't expect to be tested right away if you walk into any clinic that offers tests.
Your doctor's office
To get tested at your primary care doctor's office, you'll need to make an appointment. It's a good idea to first call ahead and ask if your doctor is even offering the tests and what criteria they are using to administer tests. If you don't meet the criteria your doctor's office is using, you likely won't be able to get tested. Per the Families First Coronavirus Response Act, your visit and test should be free of charge.
Drive-through testing site
Drive-through coronavirus testing sites have popped up all over the country. To find one near you, call your state or local department of health. If possible, call the testing site before you go. They may have certain criteria for administering tests, and if you don't meet those criteria, you might not receive a test. You may also need a doctor's order in some places. You should not be charged for testing at a drive-through site.
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Urgent care or walk-in clinic
Some urgent care facilities offer coronavirus testing at their own discretion, meaning they also have specific criteria. You should call ahead and make an appointment to find out if you can get tested and to make an appointment. Even though urgent care facilities typically accept walk-ins, they may require an appointment to reduce risks associated with COVID-19. You may need a doctor's order to get tested at an urgent care facility or walk-in clinic. As far as cost, it's likely that you'll be charged your usual copay for services at an urgent care clinic.
It's not recommended that you go straight to an emergency room for coronavirus testing -- ER visits should be reserved for life-threatening situations, and unless you have severe symptoms or are a high-risk patient, it's a better idea to visit your doctor, a drive-through site or urgent care clinic. If you do go to the ER, you will likely be billed for your stay and any related treatment, although the COVID-19 test should remain free.
The CDC has established guidelines for coronavirus testing, but most hospitals, clinics and other testing sites administer tests at their own discretion.
You can also consider testing yourself at home, now that the FDA has approved the first at-home testing kit for COVID-19, although these tests from LabCorp are rolling out to healthcare workers and first responders initially. You still need a doctor's order to purchase this test.
Who should get tested for coronavirus?
Because coronavirus testing and doctor visits related to coronavirus testing are free, it might sound tempting to go get tested just in case -- but tests are still limited despite the larger national rollout. If you're not showing any symptoms, you should refrain from getting tested.
If you are showing symptoms, especially fever, dry cough or shortness of breath, you may want to get tested, especially if you've traveled -- domestically or internationally -- recently.
If you think you might have COVID-19 but aren't quite sure, try using the CDC's self-assessment tool. This is not meant to be a diagnosis, but it can inform you if it's a good idea to visit your doctor and seek coronavirus testing. As always, call your doctor or healthcare provider before trying to get tested and follow any instructions or information they provide.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.