Explaining the COSTS of COVID Testing

1.  The cost of the TEST itself is usually covered at 100% by your insurance company. 

2.  Your Telemedicine Consult/screening might not be. Some insurances are applying this portion of the exam to your deductible, copay, coinsurance. 

 

3. Benefits differ based on  your carrier and  your benefit plan with that carrier. We have listed some links to some of the Major insurance companies to the right so you can review your insurance companies guidelines and verify your coverage. Please note that private employer groups, private insurance plans for the self-employed, and other smaller benefit plans are not required to cover the same benefits the larger company and state and federal plans cover. It is always best to call your insurance company to verify your coverage and costs.

4. If you are ASYMPTOMATIC there is a possibility insurance will not cover your TEST OR your visit.

 *** Tricare has stated they will not cover asymptomatic patients

 

*** If your insurance does not cover your visit and you receive a bill and you do not agree please call your insurance company, we bill you based on how they process your claim!  

  

Insurance COVID FAQ links on cost shares: 

Please note HMO, PPO, Medicare Advantage and other BCBS home state plans may differ.

The Un-insured Care act through UHC is covering exams/consults and testing for patients who are un-insured only. They will verify coverage and will send us your insurance name and insurance ID number to file a claim with if you chose un-insured and you actually have coverage. 

COVID FAQ's

What is COVID-19?

It is a respiratory illness that first surfaced in late 2019. It can spread from person to person. Risk of infection is higher in people who are in close proximity to people with COVID-19 such as health care workers or household members.It’s important to note that COVID-19 is one of a number of viruses in the coronavirus family. Some coronaviruses cause illness as mild as the common cold, while others have caused more severe illnesses, such as SARS and MERS.

What if I think I might have COVID-19?

The symptoms of COVID-19 can vary from mild to severe respiratory illness. Follow the CDC guidelines if you are sick. Keep in mind, about 80% of patients who have COVID-19 can be treated at home. The rate of patients who experience serious complications is only slightly higher than that of seasonal flu.

Regarding returning to work, the CDC recommends businesses not require provider notes for employees who are sick with acute respiratory illness to validate their illness or to return to work.

If you’re experiencing cold and cough symptoms and think you’ve been exposed to COVID-19, staying home and in isolation is the best way to protect yourself and others from exposure.

What do I do if I get sick?

If you are sick, stay home until:

  • At least 3 days (72 hours) have passed since resolution of fever without the use of fever-reducing medications, AND

  • Improvement in respiratory symptoms (e.g., cough, shortness of breath); AND

  • At least 7 days have passed since symptoms first appeared

If you have additional concerns, call your primary care clinic before coming in.

If you need care

If you have further questions or concerns, you can call your clinic or schedule a telephone visit with your primary care clinician. They can review your symptoms with you, answer your questions and give you more advice as needed.

 

What if I need to get tested?

Due to the limited number of available tests, we follow the current State Health Department and CDC guideline to determine whom to tests. Using clinical judgement, we may extend testing to patients with pneumonia, underlying smokers, COPD/Asthma, other lung diseases, elderly. We will not test children less than 8 years of age. 

IMPORTANT: The test is only available to individuals who have been screened by a provider and referred for the test. 

Based on the severity of your symptoms, your provider may ask you to stay home and isolate yourself. Please follow these recommendations for patients and family.

How do I protect myself and loved ones from COVID-19?

  • Avoid close contact with people who are sick.

  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

  • Avoid touching your eyes, nose and mouth.

  • Clean and disinfect frequently touched objects and surfaces.

  • Stay home when you are sick, except to get medical care.

  • If you are sick, limit close contact with others as much as possible.

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.

How to properly wash your hands

Is COVID-19 testing covered by insurance?

Testing for COVID-19 must be ordered by your provider.

Testing to establish the diagnosis of COVID-19 will be covered at 100 percent. All other medical treatment associated would be a covered benefit and follow an individual’s health insurance coverage. Please check your Summary of Benefits and Coverage for your plan details.

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