QUESTION

I need to get a COVID-19 test. Will my insurer cover the cost?

Individuals with coverage | Individual and Marketplace Health Coverage Coverage for Employees of a Large Employer Coverage for Employees of a Small Employer
ANSWER

Most likely, yes. In March 2020, Congress passed two coronavirus relief bills, which mandated that insurers cover and waive any patient cost-sharing associated with COVID-19 diagnostic testing, even if it is out of network. This mandate applies for the duration of the national public health emergency due to COVID-19. Under the mandate, insurers must cover all items and services associated with diagnostic testing for individuals, including those provided through state- or locality-administered testing sites. This includes coverage of testing for asymptomatic individuals. However, insurers are not required to cover testing needed for public health surveillance or employment purposes, although insurers may provide coverage for such tests if they choose to. Check with your insurer to make sure you understand the full scope of circumstances in which testing may be covered. Once the public health emergency expires, this mandate is no longer in place and insurers may impose cost-sharing for COVID-19 testing services. After the expiration of the public health emergency, check with your insurer to determine your coverage for COVID-19 testing. Some states may have imposed their own COVID-19 testing coverage requirements, irrespective of the federal public health emergency. Check with your state's insurance department to determine if there are additional coverage mandates in your state.

If you receive a bill from a medical provider after receiving a COVID-19 test, call your insurer and your provider to ask why you received a bill. If you disagree with the charges, you may appeal the decision not to pay the full cost.

https://www.cms.gov/files/docu...

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