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American Airlines Starts At-Home Preflight COVID-19 Testing

People on an airplane wearing face masks.

Hispanolistic / Getty Images

Key Takeaways

  • American Airlines is the first airline to offer at-home preflight COVID-19 testing for domestic flights.
  • Taking a test before you fly is not mandatory, but it might help you avoid COVID-19 restrictions in states that have them.
  • LetsGetChecked offers at-home COVID-19 tests for $129. They do not take insurance but you might be able to pay with your FSA or HSA, if you have one.

American Airlines passengers can now take a COVID-19 test at home before getting on a domestic flight to states with travel restrictions.

American Airlines is the first airline to offer at-home preflight testing to people flying within the United States. Other airlines have made at-home testing available to people flying to certain international locations.

According to American Airlines, having a negative test before boarding a flight could help travelers avoid quarantining when they arrive in states and territories that have COVID-19 restrictions.

In a press release, the company states that tests will be available to people flying to the 14 cities, states, and territories with pandemic travel limitations, including:

  • Alaska
  • Connecticut
  • District of Columbia
  • Chicago
  • Hawaii
  • Maine
  • Maryland
  • Massachusetts
  • New Hampshire
  • New York
  • Pennsylvania
  • Puerto Rico
  • Rhode Island
  • Vermont

American Airlines' preflight testing is being done by LetsGetChecked, which charges $129 per test.

What This Means For You

If you plan to fly domestically with American Airlines, you can take an at-home COVID-19 test from LetsGetChecked for $129. While it's not mandatory, the travel restrictions in each state vary. Having proof of a negative test before you fly might help you avoid restrictions when you arrive at your destination. Even if you get a negative test, it's important that you follow safety guidelines like self-isolating when necessary, wearing a face mask, and practicing proper hand hygiene.

Do You Need Proof of a Negative Test To Fly?

A spokesperson for American Airlines said testing might be mandatory depending on where you travel globally. States do not require proof of a test to enter by air domestically. The spokesperson says that “American does not require customers to obtain a test unless specified for international travel."

“Preflight test requirements vary by destination,” Rachel Warner, the communications director for American Airlines, tells Verywell. Warner suggests that customers check the airline's website for testing requirements before their flight.

“American Airlines does not receive test results from any testing provider," Warner says. “Customers traveling to international destinations that require proof of a negative test will share that proof to board.”

If you test negative, Warner suggests following the Centers for Disease Control and Prevention (CDC) guidelines. If you need to cancel your flight, Warner says that the airline has “implemented very flexible policies for customers who may need to change their travel plans."

How To Get the Test

The test costs $129 and is provided by LetsGetChecked. It’s a PCR test, which uses the most accurate type of testing technology.

LetsGetChecked accepts a Flexible Spending Account (FSA) or Health Savings Account (HSA) as a form payment but does not accept insurance. According to GoodRx, the company might provide a receipt for possible reimbursement from an insurance provider.

“We encourage customers to reach out to their insurance providers to vet whether their test may be covered," Warner says. "It’s important to note American does not make any money off the test, and the cost covers medical observation when required."

When Will You Get Results?

“In general, reverse transcriptase-polymerase chain reaction (RT-PCR) based tests tend to be the most accurate for diagnosing active COVID-19 infections,” Timothy F. Brewer, MD, a professor of medicine and epidemiology at University of California, Los Angeles, tells Verywell.

LetsGetChecked suggests that travelers buy a test at least five days before their flight. The test should arrive within 24 to 48 hours after it is purchased. To perform the test, you just need to do a nasal swab and send the kit back to the lab. You should have your results within 48 hours of the kit getting back to the lab.

In some cases, you might need to set up a video call, as some locations require sample collection to be observed and the customer's identity to be visually verified.

According to the CDC, you should get tested one to three days before flying. You should also get tested three to five days after traveling and stay home for seven days—even if you test negative. If you do not get tested for COVID-19, the CDC recommends staying home for 10 days after traveling.

Is Pre-Flight Testing Good Enough?

Kunjana Mavunda, MD, a pulmonologist from Florida who also runs an international travel clinic, tells Verywell that she doesn’t think that other airlines will follow in the footsteps of American Airlines by offering tests for domestic travel.

“At-home testing is helpful,” Mavunda says. While she believes pre-flight testing will be helpful in preventing transmission, Mavunda also notes that infected people can test negative. Still, testing will allow many people who are infected to find out, and keeping infected people off flights will decrease transmission rates.

Data on Airplane Transmission Is Lacking

Brewer says that he is not aware of “any good evidence to show that a testing strategy will reduce the already low risk of SARS-CoV-2 transmission on airplanes," adding that some passengers might feel reassured that testing decreases their chance of getting COVID-19 while flying.

“Limited data suggest that transmission rates on airplanes are already very low, particularly when passengers follow recommended prevention steps,” Brewer says. “Pre-flight testing is unlikely to have much effect on these already low rates.”

Mavunda adds that a negative test does not mean that a traveler is not infected unless the traveler isolates after the test is done.

False-Negatives Can Happen

Mavunda also points out that pre-flight testing can give false-negative results. Plus, travelers can also get infected after the testing was completed.

David Cennimo, MD

Depending on the duration of time between the test and travel, there is also a risk of infection in the interim.

— David Cennimo, MD

According to Mavunda, the airline should also ask travelers if they’ve had contact with someone who has had COVID-19. If the traveler has a cough or a fever, they shouldn’t be allowed to travel.

“Everyone should be wearing masks properly at the airport and throughout the flight and using hand sanitizer frequently,” Mavunda says. “These two things are known to be reliable.”

Naming one test provider—as American Airlines did in naming LetsGetChecked—will enable the airline to verify results. "If the provider is trustworthy, the sample was obtained properly, the correct test was done, and the traveler isolated themself after the test was done, then travel will be safer," Mavunda says.

Brewer says that any test approved by the U.S. Food and Drug Administration (FDA) proved by a certified laboratory or provider would be reasonable to use.

Check Travel Advisories

Mavunda recommends that travelers use the U.S. Department of State’s travel advisories, as well as visit a given country’s website for up-to-date information. The CDC also has a website devoted to information on domestic travel.

Lawrence O. Gostin, JD, a professor at Georgetown Law specializing in global health law, says that offering to test is a useful way to remind passengers that they should not fly if they test positive for COVID-19.

“The airline should also make clear that it will refuse to board anyone who tests positive and will waive any cancelation fees,” Gostin says, adding that people shouldn’t expect at-home tests to guarantee safety on the flight.

Testing Offers Limited Protection

Gostin also points out that passengers might not take a test—or will board a flight even if they test positive for COVID-19. "Testing provides only limited protection against transmission," Gostin says.

Gostin doesn’t support the tests being mandatory and says the airline could do a confirmatory test at the airport instead. He believes people should be able to get tested via another provider and show their test to the airline.

Kunjana Mavunda, MD

Everyone should be wearing masks properly at the airport and throughout the flight and using hand sanitizer frequently.

— Kunjana Mavunda, MD

David Cennimo, MD, an assistant professor of pediatrics infectious disease at Rutgers University in New Jersey, tells Verywell that while testing sounds like a good idea, there are some issues.

Cennimo says that while having a negative COVID-19 test before you travel should decrease the chance of exposure, there's still a chance that the test missed an incubation, and a person becomes infectious within a few days. "Depending on the duration of time between the test and travel, there is also a risk of infection in the interim," he says.

Other Precautions Still Necessary

Gostin hopes that people don’t make risky choices—for example, flying next to someone without a mask—just because their test was negative. “I do not think that any testing should decrease our precautions at this point in time," Gostin says.

Cennimo is not sure if testing will affect COVID-19 transmission, adding that it could backfire if people get tested but fail to take precautions such as masking and proper hand hygiene.

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Article Sources
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  1. American Airlines. American Airlines Offers Preflight Covid-19 Testing For All US Destinations with Travel Requirements. Updated December 15, 2020.

  2. Centers for Disease Control and Prevention (CDC). Testing and International Air Travel. Updated December 2, 2020.

  3. LetsGetChecked. Help: Do LetsGetChecked accept FSA/HSA payments?.

  4. GoodRx. Can I Test for Coronavirus At Home? The State of At-Home COVID-19 Tests. Updated October 1, 2020.