Will You Pay for the Coronavirus Test? Here’s How To Avoid It


This is an updated version of an article originally published on November 13, 2020.

The wave of Delta variant-based coronavirus infections is causing a new surge in testing, which could mean more surprise medical bills.

Congress wrote rules last spring to make most coronavirus testing free for all Americans. However, insured or uninsured patients, I found holes in these new coverage programs.

Federal law, for example, routine testing an increasing number of workplaces and schools are becoming mandatory. Some doctors and hospitals have placed unexpected fees on coronavirus testing bills, giving patients surprise fees ranging from a few dollars to over $1,000.

last year, I collected patient bills regarding the coronavirus. As part of this project, I’ve read over 100 patient stories about coronavirus testing. While many patients are happy to report no fees, others have been billed large unexpected fees or denied claims about coronavirus testing.

[Have a bill you want to share? Submit it here.]

Surprise bills hit uninsured Americans as well as those with solid coverage. Health data company Castlight estimates that 2.4 percent of coronavirus testing bills leave some of the fee to consumers, meaning millions of patients could face fees they didn’t expect.

These are some simple steps you can take to reduce your chances of becoming one of them.

Many states, counties, and cities/towns now have public testing facilities. Few patients have reported surprise medical bills from these test sites (although impossible). You can usually use your state health department website to find public testing options.

If a public testing site isn’t an option where you live, you may want to consider your primary care doctor or a federally qualified health clinic. The biggest surprise coronavirus test bills I’ve reviewed come from patients being tested in hospitals and self-contained emergency rooms. These places often charge patients something called a resort fee, which is a fee to enter the room and seek service.

Patients find that these fees can increase even when they don’t actually set foot in the facility. There was more than one patient in a Texas emergency room $1,684 resort fee stuck in the coronavirus tests with the vehicle. A patient in New York $1,394 fee for his test in a tent outside a hospital. The bulk of the bill was the resort fee. Investigative news site ProPublica, reported On how facility fees can sometimes cost 10 times the coronavirus test itself.

If you have your test done at a primary care provider or a public testing site, you don’t have to worry about such billing. They usually do not charge facility fees for coronavirus tests or other types of care.

When patients receive a surprise medical bill regarding a coronavirus test, the fees they often face are not for the test itself, but for other services the patient is not aware of.

Some of this makes sense: Many coronavirus test bills have a doctor’s visit fee that comes with them. Others make less sense, such as bills that include screenings for STDs. These extra charges seem to be a little more common in emergency rooms or when healthcare providers send their samples to outside labs. But it can also happen on public test sites: a Connecticut doctor regularly tested patients for dozens of diseases in a town car. Patients thought they were just getting tested for coronavirus.

To avoid these extra fees, ask your provider what diseases they will screen for. It could be as simple as saying: “I understand I’m getting a coronavirus test. Are there any other services you will bill me for?” Understanding this better beforehand can give you a headache later on and you can make an informed decision about what care is actually needed. If your providers can’t tell you what to bill you for, it may be a sign that you want to seek care elsewhere.

Uninsured patients have faced coronavirus bills of over $1,000, according to billing documents reviewed by The New York Times.

This type of billing is legal: Healthcare providers are not required to provide free coronavirus tests to Americans without health insurance. But they don’t have to bill patients directly. The federal government is a provider assistance fund: Healthcare providers may request reimbursement for coronavirus testing and treatment provided to those without coverage. Once again, it’s helpful to ask upfront how providers are handling uninsured patients and whether they’ve surrendered to funding. Unfortunately, they don’t have to do that – and they can keep chasing the debt.

You should also know that 17 states allow state Medicaid plans to cover coronavirus testing costs for uninsured Americans. This means your state government can pay the bill for you. You can find out if you live in one of these states. Here.

New federal laws regulate how healthcare providers and insurers can bill patients for coronavirus testing. Understanding how they work can help you withdraw fees that may not be allowed.

The new laws state that health insurers must cover coronavirus tests ordered by a doctor at no cost to patients. This means that the standard deductions and additional charges you will encounter for other services do not apply.

There is one important exception to these laws: Insurers you don’t have to cover routine coronavirus testing ordered by a school or workplace. For example, if your job requires you to have tests every week, whether you’re willing to pay those bills depends on your health plan.

For these types of tests, you’ll want to be particularly mindful of where you’re being tested and ask more questions about the fees you may have to pay. Some employers already directing your employees will be tested in public places, in part to reduce the possibility of surprise charges.

There is still some gray area for coronavirus testing that insurers should cover. The law requires insurance companies to cover other services required to take a coronavirus test, but does not define what the deduction will be. Most experts agree that the fee for a doctor’s visit is a pretty clear example of a service that needs to be qualified, and that patients faced with such bills should contact their insurance company. Other services, such as a flu test or an X-ray run alongside a coronavirus test, present a darker situation. If you are facing charges like this, you may want to enlist your doctor to explain to your insurer why additional care is needed.

One last thing to know about federal laws is that insurance companies require full coverage of out-of-network coronavirus testing. This can be especially important for patients who go to an in-network doctor but unknowingly send their sample to an off-network lab, a situation I’ve seen many times. Your health plan’s typical rules for out-of-network care shouldn’t apply to coronavirus testing. However, they can be applied to other parts of the testing experience (eg doctor visit fee), so it’s safer to stick with in-network providers whenever possible.

Another thing to look for is what billing codes your doctor used for the test visit. Most of the surprise bills I’ve reviewed involve a doctor charging a visitation fee and then sending the test to an outside lab that submits its request. The health plan may apply co-payment to a doctor’s visit because it is not clearly linked to coronavirus testing on billing records. In this case, you may need to work with your healthcare provider to have your visit recorded to show that a coronavirus test has taken place.

Almost everything I know about coronavirus test billing comes from reading bills describing the experiences of hundreds of Times readers. If you receive an invoice for coronavirus testing and treatment, please take a moment to send it. Here. It will help me continue to report on the types of charges patients face and can help identify regions of the country where patients face unusually high charges.



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