Is Covid Testing Covered by Health Insurance?

American health insurance is in disarray when compared to the rest of the developed west. In 2018 alone, over 30 million people were uninsured the entire duration of the year. In the middle of a public health crisis, this leaves many in the dark— how will they afford a test? Who will help with medical expenses should they fall ill?

These questions do not only plague the young, but also those who are elderly, many of whom wonder: is a coronavirus test covered by medicare?

In either of these cases, the waters are muddy. The standard of care is being written as we go. As such, while it’s always best to speak to an insurance agent in review of your current policy, the following is a guideline that many are adopting when deciding who gets tested and who ultimately pays.

Two Types of Test

At the moment, there are two types of COVID-19 tests available and each is used for a different purpose.

First, there is the PCR test. Taking the form of a nasal swab, the PCR measures whether you may be capable of spreading the virus. Commonly, this type of test is given to individuals who are presently showing symptoms and meet CDC testing criteria. These tests are represented at public covid drive-through centers in addition to take-home testing kits.

Second, there is an antibody test which is done by drawing blood. Unlike the PCR, this test looks for COVID-19 antibodies in your bloodstream. Should antibodies be present, it is likely that you have either had the virus asymptomatically, or, have been exposed and developed an immune response. These tests are generally done at labs, clinics, hospitals, and some doctors offices.

Insurance Coverage: Necessary vs. Employer Mandated Tests

There is a debate in the insurance community regarding the “runaway costs” of mass public testings. In addition, there is a rising number of employers mandating the consistent testing of their staff, especially those who work with high-risk populations such as nursing home staff. The result of these mandates is that care workers are being tested at least once a week and the jury is still out on whether they will be compensated.

At the moment, insurance companies are only mandated to cover testing costs when deemed “medically necessary” as outlined by the Families First Coronavirus Response Act (FFCRA). This leaves many individuals unprotected against the cost of periodic testing.

While there is a growing pushback in the legal community to allow insurance companies to cover the cost of this type of healthcare, especially when mandated by an employer, the battle is far from over. As such, it’s best to speak with your insurance provider about how best to proceed and whether or not your test will be fully insured.

Mental Health Coverage

Due to the strain COVID has placed on many individuals, there is a growing need and leniency for responsive mental health services. As such, insurance plans who did not always cover for mental health costs are growing more forgiving in their policies, seeing some types of mental health care such as prescriptions drugs and telehealth services as necessary additions to policy coverage.

Again, as so many pieces of information are quick to change, it’s best to speak with your insurance provider to determine if any changes to your plan are long or short-term in nature.

Special Considerations for Medicare Recipients

If you are currently covered by Medicare Part B, the Original Medicare, or Medicare Advantage, you will likely be covered for the full amount of your test, whether it is a PCR or antibody assessment.

Casa Grande Insurance Agents

With the constant changes in landscape as the coronavirus pandemic reaches a boiling point, it’s important to make sure you know exactly what your plan does and does not cover should you or a loved one get sick. Furthermore, with open enrollment in the near future, it’s also time to think about whether your current plan is best for you or whether you need a change.

At the Gebhardt Insurance Group, we offer a variety of coverage from a host of major insurance carriers with an experienced staff that can help you determine the coverage you need. We can help everyone from individuals looking for a basic health policy to families, persons with pre-existing conditions, and even those who are looking to purchase life insurance.

If you have any questions, give us a call at 520-836-3244 to get a quote and make an appointment to take the final steps in insuring your business.

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Steve Gebhardt

Gebhardt Insurance Group was honored by AAA Insurance for being the top New Policy Agency in Arizona for 2013 and achieving the "Emerald Achievement Award."

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