Are Coronavirus Tests Free?

With cases of COVID-19 spiking across the country, testing for the virus is likely to go up. So, what’s that going to cost you? 

Legislation passed at the beginning of the COVID-19 outbreak required that insurers cover both rapid (saliva) and PCR (nose swab) testing for free with no copayments or deductible requirements, according to the Kaiser Family Foundation. The caveat is that you have to have been exposed or have symptoms of the virus. Employer-required tests don’t qualify for the covered testing. 

For People Without Health Insurance

Many places are offering free testing to people without insurance, and the federal government has set aside money to pay for that, says Cheryl Fish-Parcham, Director of Access Initiatives at Families USA, a national, nonpartisan consumer healthcare advocacy organization, based in Washington, D.C.

There is no requirement, however, that clinics or physicians use the federal program, so someone uninsured could still be charged for testing by their healthcare provider if that provider is not taking government money. And the program doesn’t cover costs beyond the test itself, so if you get a bill for a physician visit, neither insurance nor the federal government will cover that. 

Fish-Parcham advises looking online at your local or state health department’s website to learn where free testing is offered to people without insurance or contact a local community health center. “Many community health centers that generally provide services on a sliding fee scale are now providing free testing to people without insurance,” she tells Verywell.

For People With Health Insurance

Almost all health insurance plans, whether private (such as employer-sponsored) or public (Medicare, Medicaid, and the Children’s Health Insurance Program) must cover FDA-approved COVID-19 tests and costs associated with diagnostic testing, as long as the tests are deemed medically-appropriate by an attending healthcare provider. (This does not have to be your own doctor.) This has been the case since the enactment of the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March, and will continue as long as COVID-19 is deemed a public health emergency.

The only plans excluded are short-term plans that cover limited health needs. Tests are generally covered if a person has been exposed to someone with the virus or is exhibiting symptoms.

Paying Out-of-Pocket

Paying out-of-pocket can get expensive, and can happen if you get tested at a facility that is out-of-network for your insurance policy. You'll likely have to pay for the test upfront and submit a claim to your health plan for reimbursement. A July review by the Kaiser Family Foundation found a range of $36 to $180 per test if you’re paying out-of-pocket, with the rapid saliva tests coming in at lower cost, though they can also be less accurate.

The costs partly depend where you live and the type of laboratory where the test is processed, according to Joshua Sharfstein, MD, MPH, Vice Dean for Public Health Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public Health. While private healthcare plans are required to pay the full price posted online for any given COVID-19 test, even if it is out-of-network, bills can remain high if no price is posted online.

Dealing With Surprise Bills

Some patients have been billed thousands of dollars for COVID-19 tests when the labs doing the testing were not in their insurers’ network. On November 16, the Association of Health Insurance Plans (AHIP), the trade association representing many health insurers, reported the results of a member survey that found that the average cost of a COVID-19 test for someone paying out of pocket is $130, but that out-of-network labs were billing more than $185 for nearly half of diagnostic tests. 

The New York Times found that about 2.4% of COVID-19 tests billed to insurers left patients responsible for some portion of payment, though in three cases the paper reported on, the fees were returned or cancelled. It’s totally within your right to appeal any insurance charges you didn’t expect or that seem excessive. 

AHIP has several recommendations for lowering the costs of COVID-19 tests that are likely to be discussed when the next session of Congress begins in January:

• Congress should make the financial investment needed to ensure that Americans have access to all necessary COVID-19 testing.
• Congress should eliminate the ability for price gouging to occur by setting a reasonable market-based pricing benchmark for tests delivered out of network. 
• Policymakers should accelerate the availability of consumer-friendly, rapid, and accurate tests that lower costs and ease the capacity and supply constraints of providers and labs.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.