COVID-19 Tests: A financial warning for consumers

 

The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security (CARES) Acts required health coverage for the COVID-19 test – including the test itself, the related visit, and other services related to the testing with no cost-sharing for individuals covered by private health plans, Medicare and Medicaid. The CARES Act, passed by Congress in March 2020, includes a provision that states insurers must pay for an out-of-network COVID-19 test at the price the testing facility lists on its website. But it sets no maximum for the cost of the tests.

Although providers are required to post the price for a COVID-19 test on a public website, there is no regulated price for the test. However, Medicare covers the testing without cost-sharing for patients and reimburses providers $51 – $100 per diagnostic test depending on the type of test administered. This price contrasts sharply with the outrageous charges made by certain providers that can run from $2,000 – $5,000 per test.

There is a better way to control the cost of testing. Here are a few reminders to help protect consumers from balance billing, and insurance companies or your employer from a costly claim.

  1. Call your doctor’s office if you are experiencing symptoms like a fever, cough, fatigue or if you think you may have been exposed to the virus. Your primary care physician will schedule and direct you to an in-network testing site.
  2. DO NOT go directly to an emergency room. There are collateral charges for a COVID-19 test at an ER that you will be responsible to pay. Before going to an ER for the test, ask yourself: Would I call an ambulance right now if I suspect exposure to the virus?
  3. For a free COVID-19 test, call your local county health department to schedule a test. If the appointment results in an extended waiting period, call or go to an urgent care facility and request a test.
  4. If you are insured, stay in-network with your health carrier. If you are uninsured, you should utilize the testing resources of your local county health department.
  5. If your symptoms warrant a test, follow the posted CDC guidelines.

For more information, click here.

Teaching Suggestions

  • Ask students if anyone in their family received a COVID-19 vaccine.  If so, enquire if there was cost-sharing.
  • If the cost of each COVID-19 test, by law, is free to the public with health coverage, how can some providers charge from $2,000 to $5,000 per test?

Discussion Questions

  1. Why is it important to first call your primary care physician if you experience symptoms like fever, cough, fatigue or if you believe you have been exposed to the virus?
  2. If you are uninsured, what are your options to receive free COVID-19 test?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Categories: Chapter 9, Health Insurance, Uncategorized | Tags: | Leave a comment

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