The coronavirus pandemic has had a tremendous impact on the daily lives of millions of Americans. If you feel you may have contracted the disease, you may be considering getting tested for the virus. But will your health insurance cover COVID testing? Keep reading to find out.
Insurance and COVID Tests
If you have health insurance, COVID tests are likely covered. This is because the Families First Coronavirus Response Act which was passed by Congress has required all health plans to fully pay for any testing that has been deemed medically necessary. Though, there is a gray area, as people without symptoms may also desire to be tested for the virus. In these cases, the test may not be medically necessary, so insurance doesn’t always have to cover it.
Does Medicare Cover COVID Tests?
If you are a Medicare beneficiary, coronavirus tests won’t cost you anything. As long as you get the test from a laboratory, pharmacy, doctor, or hospital, Medicare will cover testing in your local area. Medicare will also cover related tests that look for respiratory conditions that could help diagnose COVID-19. If you need antibody tests, monoclonal antibody treatments, or the COVID-19 vaccine, these services are covered by Medicare too.
How Do Other Insurance Plans Cover COVID Tests?
If you have marketplace insurance or another private insurance plan, you may be wondering how your policy covers COVID tests or if they cover them at all. While rules vary from plan to plan, you can expect that your insurance will cover COVID tests. Here are common rules for several different types of insurance.
COVID testing with Health Maintenance Organization (HMO) Plans
If you have an HMO and feel you need to have a COVID-19 test done, you should contact your doctor immediately. HMO plans typically require you to seek care from in-network providers, so this step is important. Your primary care physician will help you coordinate your testing with an in-network lab. In most cases, your insurance plan should cover diagnostic testing for COVID-19.
COVID testing with Preferred Provider Organization (PPO)
PPO plans allow members to seek care from out-of-network providers, so you won’t have to go to an in-network provider to get tested. Though, you may benefit from doing so. If there is a cost associated with the test, it may be cheaper to have your doctor connect you with an in-network test provider.
COVID testing with Exclusive Provider Organization (EPO) Plans
If you have an EPO plan, your insurance provider restricts you to only seeing in-network health care providers. Though, you won’t need a referral to see any specialists. To receive a COVID test that is covered by your EPO plan, you must contact your primary care physician and have them connect you to an in-network lab or testing location.
Find a Plan That Covers COVID Tests
If you need a COVID test, proper health insurance can help you afford it. To find a policy that offers you easy access to COVID tests, get in touch with Kannonball Insurance. We can help you shop and compare plans in your area.