COVID-19 Tests: A financial warning for consumers

By Oklahoma Insurance Commissioner Glen Mulready 

As of December 1, 2020, the Oklahoma State Department of Health has reported over 200,000 cases of the Coronavirus (COVID-19) among Oklahomans since March. Yet, thousands more Oklahoma citizens have also tested negative for the virus. The cost of each test, by law, is free to the public with health coverage, but we have received numerous complaints of a standard COVID-19 diagnostic test costing thousands of dollars. This is an issue we don’t regulate, but consumers shouldn’t have to make these financial choices. There but are multiple alternatives to the cost of the test that avoid unnecessary and wasteful expenditures.

COVID-19 diagnostic tests are available at over 80 local county health department sites across the State. The diagnostic test is also available at no cost to Oklahomans through their health coverage. The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security (CARES) Act required health coverage for the 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, includes a provision that says 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.