You should be getting your COVID-19 testing for free, state says – KCRA Sacramento
The demand for COVID-19 testing is especially high right now, but some people are still hesitant to seek out tests at community sites, thinking it’s going to cost them a lot of money out-of-pocket.This is an issue KCRA 3 has followed for months.For updated information, KCRA 3 contacted California’s Department of Managed Health Care (DMHC).| MORE | COVID-19 in California: Find testing info, omicron updates, vaccine rates and boostersIt says health plans must cover both PCR and antigen tests, including rapid tests, at NO cost to enrollees. That’s because the tests are meant to detect/help mitigate the spread of COVID-19.Federal guidance requires health plans to provide testing at no cost to everyone meaning:You do not need to have symptoms or to have been exposed to COVID-19.You do not need to be an “essential worker” to get tested.You can go to any COVID-19 testing provider that’s authorized or licensed by the state.That provider doesn’t have to be in your health plan’s or health insurer’s provider network.You do not need to get permission from your health plan or health insurer before going to get a COVID-19 test.You should not have to make a co-payment for a COVID-19 test.Individuals can get up to 8 over-the-counter COVID-19 at-home tests per month covered by their health insuranceThe federal government also announced the following this week:”…beginning on January 15, 2022, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance.”Insurance companies and health plans are required to cover 8 free over-the-counter at-home tests per covered individual per month.”That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan per month.”There is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.”This program does not apply to people without health insurance or those on Medicare. But the federal government is working on a website where those patients and others can soon request at-home tests delivered through the mail for free. The U.S. Department of Health and Human Services is also providing up to 50 million free at-home tests to community health centers and Medicare-certified health clinics for free distribution. Access to free at-home testing is something UC Davis Health professor of clinical pathology, Nam Tran supports.“I think it’s great. Obviously, the crunch is not just trying to find kits, it’s also affording them. Many families that make a lot less have a tough time keeping up with the cost of these kits,” Tran explained. “That becomes a huge economic burden – especially in those communities that have lower income that also have a higher risk. So that’s one of the biggest challenges we face now is maintaining accessibility to populations that need it.”If you don’t have health insurance and are in need COVID-19 testing, according to the California Department of Public Health the government pays for all necessary COVID-19 testing and care.For further resources about what to do if you received a bill and need help filing a complaint, contact DMHC’s help center at www.HealthHelp.ca.gov or call 1-888-466-2219.Have you been charged for a COVID-19 test and had trouble being reimbursed? We want to hear about it. Email us at web@kcra.com– KCRA 3’s Daniel Macht contributed to this story.
The demand for COVID-19 testing is especially high right now, but some people are still hesitant to seek out tests at community sites, thinking it’s going to cost them a lot of money out-of-pocket.
This is an issue KCRA 3 has followed for months.
For updated information, KCRA 3 contacted California’s Department of Managed Health Care (DMHC).
| MORE | COVID-19 in California: Find testing info, omicron updates, vaccine rates and boosters
It says health plans must cover both PCR and antigen tests, including rapid tests, at NO cost to enrollees. That’s because the tests are meant to detect/help mitigate the spread of COVID-19.
Federal guidance requires health plans to provide testing at no cost to everyone meaning:
You do not need to have symptoms or to have been exposed to COVID-19.You do not need to be an “essential worker” to get tested.You can go to any COVID-19 testing provider that’s authorized or licensed by the state.That provider doesn’t have to be in your health plan’s or health insurer’s provider network.You do not need to get permission from your health plan or health insurer before going to get a COVID-19 test.You should not have to make a co-payment for a COVID-19 test.
Individuals can get up to 8 over-the-counter COVID-19 at-home tests per month covered by their health insurance
The federal government also announced the following this week:
“…beginning on January 15, 2022, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance.”Insurance companies and health plans are required to cover 8 free over-the-counter at-home tests per covered individual per month.”That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan per month.
“There is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.”
This program does not apply to people without health insurance or those on Medicare. But the federal government is working on a website where those patients and others can soon request at-home tests delivered through the mail for free. The U.S. Department of Health and Human Services is also providing up to 50 million free at-home tests to community health centers and Medicare-certified health clinics for free distribution.
Access to free at-home testing is something UC Davis Health professor of clinical pathology, Nam Tran supports.
“I think it’s great. Obviously, the crunch is not just trying to find kits, it’s also affording them. Many families that make a lot less have a tough time keeping up with the cost of these kits,” Tran explained. “That becomes a huge economic burden – especially in those communities that have lower income that also have a higher risk. So that’s one of the biggest challenges we face now is maintaining accessibility to populations that need it.”
If you don’t have health insurance and are in need COVID-19 testing, according to the California Department of Public Health the government pays for all necessary COVID-19 testing and care.
For further resources about what to do if you received a bill and need help filing a complaint, contact DMHC’s help center at www.HealthHelp.ca.gov or call 1-888-466-2219.
Have you been charged for a COVID-19 test and had trouble being reimbursed? We want to hear about it. Email us at web@kcra.com
— KCRA 3’s Daniel Macht contributed to this story.
