How to Pay for Coronavirus Tests and Treatments
Testing will be free, but you could still be on the hook for the substantial cost of your care. What you need to know.
The federal government took more steps over the past few days to expand free testing for the coronavirus and said a million more tests would soon be available. And this week the Senate passed and President Donald Trump signed legislation to make testing for the virus free for many people who need it, including the uninsured.
In addition to free tests, the “Families First Coronavirus Response Act” will also require that coronavirus-related doctor visits be covered by all private insurers, and public programs such as Medicare and Medicaid, and for the uninsured, without any cost to the patient, says Loren Adler, associate director at the University of Southern California-Brookings Schaeffer Initiative for Health Policy, who recently co-authored an analysis of the bill.
However, while the test itself would be free and a doctor visit would be covered under the legislation, the cost of being treated for COVID-19, the disease cause by the virus, could still be expensive, especially if you need to go to the emergency room or are admitted to the hospital, Adler says.
If You Need to Visit a Doctor
Now that the Families First Act has been signed, if you need to visit the doctor’s office for coronavirus testing your insurance should cover the cost of the test and related office visit.
But just because the test and the doctor visit are free does not mean you should be tested if you don’t exhibit any symptoms, says Robert McLean, M.D., president of the American College of Physicians and a practicing physician at the Northeast Medical Group of Yale New Haven Health in Connecticut.
If you have a fever, a dry cough, or shortness of breath, or you’ve traveled recently and have breathing problems, get a test, McLean says. To do that, you’ll need a doctor’s recommendation. (Read more about when you should be tested if you think you have symptoms of the coronavirus.)
In addition, any medical care or treatments you receive in the doctor’s office, or in places such as urgent care or walk-in clinics, will not be free but instead will be billed through your insurance. So you will still have your typical co-pays and other out-of-pocket expenses for that care.
If You Are Admitted to the Hospital
If you end up testing positive for the coronavirus and are being admitted to the hospital, you can expect to be charged for your care. “None of the federal legislative actions address the cost of treatment, which can be very high,” Adler says.
Consumers in this situation can expect “treatment for an infectious disease to be typically covered in accordance with an individual’s benefit plan,” says Kristine Grown, a senior vice president and spokesperson for AHIP.
Good to know: Most people who test positive are okay to practice self-care at home, McLean says. “Only if a patient is sick with severe shortness of breath, weakness, and is unable to stay adequately hydrated, should they go to emergency department,” he says.
Still Watch for Surprise Medical Bills
Last week, Trump announced that health insurers had pledged to end any surprise medical bills related to the coronavirus. Surprise billing can happen when you get care from an out-of-network healthcare provider or hospital—and it’s most likely to occur in an emergency when you have little or no control over who cares for you.
But it’s really doctors and hospitals who send patients the surprise, out-of-network bills, Adler says, not insurance companies. “You’re still best off going to a hospital in your insurer’s network,” he says.
And because so many people may face emergency situations and need immediate care in the ER or hospitalization, “patients who contract the virus will still face significant financial risk,” says Chuck Bell, senior policy advocate for Consumer Reports, which advocates for stronger surprise medical bill regulations.
As of Friday, only Blue Cross Blue Shield had made a public statement to Consumer Reports in regard to surprise billing.
“We have been working with lawmakers for months to end surprise bills and we agree with the Vice President that there should be no surprise bills during this outbreak,” Justine Handelman, M.D., senior vice president in the office of policy and representation at the Blue Cross Blue Shield Association said in a statement to CR. “We are committed to having people get the care they need when they need it."
“During this public health crisis, we believe everyone in the healthcare system should—and will—act together to ensure that patients can access the care they need without added worry about unexpected or excessive charges,” the statement said.
None of the other major insurers we contacted responded to our request for information about how they would cease surprise billing related to the coronavirus.
“For nearly a year, Congress has been considering legislation in both the House and Senate to fully protect patients against surprise charges for emergency and non-emergency care,” says CR’s Bell. “We are urging Congress to move forward now, to pass this legislation in the next several weeks.”
Before you need medical care of any kind, Adler says to learn which emergency rooms are considered in-network by your insurance to help minimize the risk of out-of-network charges. (Read more about how to fight surprise medical bills.)
Read more about how protect yourself from the coronavirus.
Editor’s Note: This article, originally published March 17, 2020, was updated to include the news that the Senate passed and Trump signed coronavirus legislation. Another updated clarified that the comment from Blue Cross Blue Shield came from Justine Handelman, M.D., senior vice president in the office of policy and representation.