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Should I have to pay for my COVID-19 test?

COVID-19 testing should be free, but some people may be charged depending on where they access care. Here's what you need to know.
Covid testing
People wait in line at a COVID-19 testing center in Queens, N.Y. on March 8, 2021.Michael Nagle / Xinhua via Getty Images

Like the coronavirus vaccine, testing for COVID-19 is "free to anyone" in the United States, including people without health insurance.

The U.S. Department of Health and Human Services (HHS) has partnered with pharmacies and retail companies across the country to provide free, accessible testing. Information about testing by state is available on the department's website.

"The patient responsibility is waived," said Dr. Gerard Brogan, chief revenue officer for Northwell Health and professor of emergency medicine at Zucker School of Medicine in New York. "If they have insurance, insurance will be billed, but the patient portion of what might be their deductible or copay or coinsurance, which can vary depending on the plan, is currently being waived."

Where can people access free COVID-19 tests?

HHS has partnered with pharmacies and retailers, including CVS, Rite Aid, Walgreens and Walmart, to provide COVID-19 testing. Local independent pharmacies also provide free testing. Information about specific testing sites can be found online.

At-home testing is also becoming an option, with the Food and Drug Administration (FDA) beginning to approve over-the-counter rapid coronavirus tests. According to a list of frequently asked questions published by the Centers for Medicaid and Medicare Services, at-home tests should also be covered when an at-home test is ordered by an attending health care provider "who has determined that the test is medically appropriate for the individual."

Guidance from the Biden Administration, released in early 2021, said that insurance providers must cover testing without cost sharing even for people who are asymptomatic.

Who funds COVID-19 testing?

The funding for coronavirus testing was first allocated by the Families First Coronavirus Response Act (FFCRA). Since the legislation was passed on March 18, 2020, all forms of public and private insurance are required to cover the costs of COVID-19 testing using tests approved by the FDA, so long as the test is deemed medically appropriate by a health care provider. Insurance providers must also cover the cost of facility fees related to the administration of the test.

According to a list of frequently asked questions published by the Centers for Medicaid and Medicare Services, the coverage required by FFCRA does not put a limit on how many coronavirus tests a person can receive free of charge, so long as those tests are "diagnostic and medically appropriate for the individual."

The CARES Act, also passed in March 2020, requires that private insurance plans cover out-of-network coronavirus tests, and says that if people are charged upfront for testing, the patient should submit the bill to their health plan for reimbursement.

How much does COVID-19 testing cost?

The cost of coronavirus testing can vary. In July, an analysis by the Kaiser Family Foundation found that the out-of-pocket cost of testing at hospitals can range between $20 and $850 per diagnostic test, with about 51% of tests costing between $100 and $199 per test.

Brogan said that the cost of testing incorporates the fee a healthcare provider pays to obtain testing kits from manufacturers and the costs of lab technicians and equipment. The Kaiser Family Foundation analysis noted that cost can vary based on the type of test (rapid antigen tests tend to be cheaper than PCR tests), where the test was processed, and more.

"COVID testing, in terms of the costs and the charges, is no different than the flu testing that is done in medical offices or in the ER," Brogan said.

What should you do if you're billed for a COVID-19 test?

According to an investigation by the New York Times in September, around 2.4 percent of coronavirus tests billed to insurers left people responsible for "some portion of payment." Brogan recommends that if you do get a charge from your insurance that you call the site you were tested at.

"It's possible, someone enters a wrong (billing) code and by mistake, a patient gets what either is a bill or ... the explanation of benefits, which shows what a person normally would have paid but are not responsible for," said Brogan.

Brogan said that people may also be charged for other diagnostic tests, especially if they go to an emergency room or urgent care to seek testing.

"We have heard of patients complain that they got an ER bill when they thought they were just getting COVID test, but those are people that walked into an ER with symptoms and said "I want a COVID test because I have a headache and I'm short of breath,' and under federal law the ER has to do a medical exam," Brogan explained. Those medical exams are not covered by the FFRCA, so patients might be billed for other types of diagnostic tests.

You can also try appealing to your insurance company.