What Will Coronavirus Testing Cost Me?

As part of Northwell Health Physician Partners, we at Westchester Health would like to share the following article from Northwell Health concerning aspects of the COVID-19 outbreak. 

In brief, the article discusses:

  • What you need to know before getting tested for COVID-19
  • What COVID-19 testing costs nationwide
  • You need to be screened by a doctor before getting tested
  • Telemedicine and drive-thru testing are additional options
  • Self-test kits not yet available

The full article is reproduced below.

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Coronavirus Testing: What Will It Cost You?

Less uncertainty. More transparency.

You wake up feeling under the weather. Your throat is sore, you seem to have a cough, and the tiny screen on your thermometer has just informed you that you also have a mild fever. You begin to anxiously ask yourself a million questions: Do I have coronavirus? Do I need to get tested? How much does it cost? What if it’s more than I can afford?

The truth is, coronavirus—also known as COVID-19—has caused its fair share of financial uncertainty. There are a lot of unknowns and a vast amount of information is circulating, so it can be overwhelming to say the least. When it comes to your health, financial transparency matters—especially in uncertain times like these. Here’s what you—and your wallet—need to know before getting tested for COVID-19.

What does COVID-19 testing cost?

Lab testing for COVID-19 is fully covered. “Health plans and insurers are required to cover 100% of the cost of testing. There is no cost sharing, deductible, copay, or coinsurance expense to the patient,” explains Richard Tesoriero, vice president of business and operational performance at Northwell Health Labs. “Additionally, there are no prior authorization or medical management limitations. Marketplace prices for testing is varied, but the average range right now is $50 to $200.”

Here’s the nationwide pricing structure for COVID-19 testing—based on what labs are currently charging insurance providers:*

  • Public labs: Tests run by the Centers for Disease Control and Prevention (CDC), state, or city public health labs are 100% covered through the Department of Health (DOH).
  • Private/Third-party labs: Tests completed at private or academic labs are $195. The good news is that federal law mandates private insurers waive all cost-sharing, copays, and deductibles for coronavirus testing, including in New York.
  • Medicare/Medicaid: Tests and copays for these patients are 100% covered through their insurance providers.
  • Uninsured patients: While uninsured patients will not be charged for the cost of the test itself, they may still incur charges for associated care that they receive. For this reason, uninsured patients are advised to seek out testing at public labs where costs will be covered by the DOH.

*Pricing structure rates current as of March 23, 2020.

Do I need doctor approval before testing?

Since the number of available tests is limited, you’ll most likely need to be screened by a physician and/or healthcare provider first in order to get approval for testing. This pertains to everyone regardless of their insurance status.

What if I go to the ER or an urgent care center?

If you visit the ER or urgent care center, the likelihood is that you won’t be tested for COVID-19 unless you have severe symptoms. But they might want to run other tests to rule out the coronavirus. The CDC recommends calling your primary care physician or an urgent care physician ahead of time so that they can take the necessary steps to prepare for your visit and protect others from possible exposure.

In the event you are tested for COVID-19, you won’t be charged for the screening itself. You will, however, still be billed for any additional services or treatment you may receive.

Are there other ways to get tested or assessed?

Many doctors and medical practices have begun to offer telemedicine to their patients. If you feel sick and would like to speak with a doctor, you can use this service for an initial assessment. Virtual care sessions are billed as regular office visits, and costs may vary depending on your insurance plan. Check with your provider to see if they offer telehealth services and if you qualify.

Drive-thru testing is also available in various locations throughout New York state and the surrounding areas. In order to make an appointment, a referral from a doctor may be required, or you will be instructed to call in order to be evaluated by a medical professional. You must also have qualifying symptoms or fall into a high-risk category, such as being 60 or older, or having a pre-existing health condition. Lab fees will apply. New York patients can call (888) 364-3065.

At the time of publishing, there are no at-home test kits approved by the U.S. Food and Drug Administration (FDA), though some may be in the works. According to the FDA, “The FDA sees the public health value in expanding the availability of COVID-19 testing through safe and accurate tests that may include home collection, and we are actively working with test developers in this space.”

Learn what Westchester Health is doing to protect our patients and staff against COVID-19

We are here to provide the care you need, when you need it. To learn what precautions we’re taking to minimize the spread of COVID-19 and keep you safe, visit our Coronavirus Digital Resource Center. To learn how we’re responding to the outbreak and what to do if you’re feeling sick, visit our FAQ page (frequently asked questions). Whenever, wherever you need us, we’re here for you.

by Blog