What to know about COVID-19 testing and treatment costs
a new wave of covid-19 hits the city, and health experts are not sure of the impact it will have; Mayor Eric Adams tested positive on Sunday and is working remotely, according to City Hall.
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Many residents now also face another new uncertainty: the cost of covid-related care.
Reading: How often will insurance cover covid testing
Last month, a federal government fund that reimbursed pharmacies, hospitals and other health care providers for the costs of covid-related care dried up, without Congress refilling it.
Since then, many private health providers, no longer able to receive money from the government to cover covid-19 costs for the uninsured, or costs that co-pay fees may have covered, have begun charging for said attention. testing at city-run sites remains free.
Reports have begun to fill social media of people surprised by quotes or charges for pcr tests that have been free for much of the pandemic.
The cost wave, which comes as the omicron ba.2 subvariant is causing a slow rise in infections in the city, worries health experts and doctors. making testing prohibitively expensive, especially for the uninsured or underinsured, they say, will only exacerbate existing health care disparities and make people in general less likely to seek medical care.
It’s also unclear whether Congress will provide enough funding to restore the reimbursement program, leaving uninsured Americans paying for testing and treatment at private providers indefinitely.
“It does long-term damage every time someone shows up for care and is surprised with a giant bill,” said dr. stephanie woolhandler, professor of urban public health at hunter college. “It’s harm for covid, it’s harm for when the next pandemic comes, it’s harm when someone has a heart attack.”
here’s what you need to know about the costs of covid-related care in new york city.
can a healthcare provider charge for a covid-19 vaccine?
no, according to jennifer tolbert, director of state health reform at the kaiser family foundation.
Any health care provider or government that has agreed to distribute vaccines must comply with federal rules that prohibit charging anyone with an insurance history for the vaccine.
The federal government has already covered the costs of purchasing the vaccines, as well as shipping to states, cities, and health care providers. The remaining costs associated with administering the vaccines may be billed to government insurance or private insurance, Tolbert said.
“no entity can charge anyone for the cost of the vaccine, because it has already been paid for,” said tolbert.
does new york city still offer free testing, vaccination and treatment for covid-19?
PCR testing for covid-19 is free at all city-run providers, including nyc health network and hospitals and gotham health clinics. For a list of locations and times, including regular rapid test pick-up locations, click here.
If you test positive for covid-19 and experience symptoms, you may be eligible for free treatment provided and delivered by the city. (Mayor Adams is currently taking free antiviral pills provided by the city, according to his representatives.) the phone line to register for treatment is open from 9 a.m. to 5 p.m. m. to 9 p.m. m., seven days a week, on 212-covid19.
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The city plans to distribute 6.33 million rapid home tests during April at drop-off locations around the city and through 2,500 partner organizations, according to adam shrier, spokesperson for the city’s test and trace initiative. city. These tests are separate from the city’s ongoing testing of schools, said Shrier, which administers PCR tests each week to at least 10% of students who have opted into the testing program.
For a list of pickup locations, visit this website.
Community organizations can join a waiting list to distribute home tests here.
There are two tests in each rapid test kit. should i use both every time i test?
Health experts say that having two tests increases the chance of getting an accurate result.
Studies have suggested that false positives, receiving a test result that says you have covid-19 when you don’t, are rare, meaning that when you test positive on a rapid test, it’s very likely that you actually have covid-19. false negatives (a test result that says you don’t have covid-19 when you do) are more common. Two negative tests, medical experts say, means you’re highly unlikely to have Covid-19, while at least one positive test suggests you’re likely infected.
if i have medicaid or medicare, can i be charged for covid-related treatment?
If you have Medicaid, you should be able to get tested, treated and vaccinated for COVID-19 for free, Tolbert said.
“people who receive medicaid should not face any cost for these services,” tolbert said.
People with Medicare, the government insurance for people age 65 and older, do not have to pay covid testing costs, but may face cost sharing, such as copays, for covid treatment, such as when admitted in a hospital or visit a doctor, he said.
Can I have a quick insurance test?
If you haven’t already, you can get up to two sets of COVID-19 home tests (that’s four tests total) through the federal government by ordering from this site.
Private insurers are required to cover up to eight rapid tests per member per month. This policy does not apply to people with Medicaid or Medicare Advantage, according to the Kaiser Family Foundation. however, insurers may limit reimbursement for tests to $12 per test; some pharmacies are selling tests for double that amount or more.
If you have an HSA or FSA spending account: According to the Internal Revenue Service, rapid tests (as well as masks and some other protective equipment) are eligible for reimbursement through these programs. call your particular program to confirm the reimbursement process.
Which private providers charge for testing and which don’t?
Since the federal money stopped flowing, there is a mix of private providers and pharmacies that are still offering free covid-19 services and others that are not.
citymd, a popular chain of urgent care clinics, charges for Covid-19 tests and treatments, according to its website. For people with insurance, visiting a CityMD location for COVID-related care may result in a copay or deductible payment. On social media, some people have reported being quoted or charged hundreds of dollars for covid-19 tests at MD locations around the city. A citymd representative did not respond to a request for comment.
We are Community Care, a network of providers with clinics in every county except Staten Island, serving many immigrant patients and have continued to provide free COVID-19 testing and immunizations. (does not provide treatment for covid-19). Somos has a contract with New York City and the state to receive payment for providing free COVID-19 care, according to a company spokesperson.
Walgreens, owner of the pharmaceutical brand Duane Reade, and CVS do not charge patients for covid-19 tests, according to representatives of the companies. Walgreens is also offering COVID-19 treatments at no cost.
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rite aid said it was offering free tests until May, through a contract with the city’s health and human services department. people covered by medicare part b can also get up to eight rapid home tests per month at riteaid stores.
why doesn’t the federal government cover these costs anymore?
During negotiations on the federal budget last month, congressional leaders deadlocked over a large tranche of money requested by the white house to continue funding various covid-related programs. congress ultimately passed the budget without covid-19 resources, leaving a crucial program, the covid-19 uninsured program, unfunded.
On March 22, the program stopped accepting reimbursement requests from health care providers for COVID-19 tests and for vaccines on April 5. Without the money, the White House says, it can’t buy additional tests, treatments or even more vaccines when current supplies run out.
Senate leaders announced last week that they reached a deal on covid-19 funding, for a much smaller amount than originally requested by the white house: $10 billion of the $22.5 billion expected. But this week, Senate Republicans blocked debate on the bill, seeking to get Democratic leaders to vote on an amendment that would preserve the ceiling on immigrants allowed into the country set by former President Donald Trump.
The Senate is in spring recess and won’t be able to accept the bill until the end of the month.
will congress refill the reimbursement fund?
Health experts are still hopeful that funding will be reinstated, but say the uncertainty created since it expired has hurt public health goals, especially in undocumented communities where insurance coverage is low.
“It is critical that we get these funds back,” woolhandler said.
but tolbert said it’s not clear if the federal government will get enough money from congress to replenish the rebate fund.
The talking points posted on the Senate’s $10 billion compromise do not require any of the money to go to the reimbursement fund, he said. The fund, created by the Trump administration early in the pandemic, is not codified in law. it has already spent more than $19 billion to reimburse providers for testing, treatment and administration of vaccines for the uninsured.
The Senate deal, however, requires $5 billion to be spent on COVID-19 treatments, leaving $5 billion for vaccine and testing costs, including reimbursement from the uninsured fund.
with the fda considering approving a second booster dose for all adults, the federal government may have to spend a substantial portion of that $5 billion on more vaccines, and spending on administering vaccines to people without insurance can beat reimbursement for testing and treatment for that group.
“At the end of the day, that’s not a lot of money if you want to make sure vaccines stay available to everyone who needs them,” Tolbert said.
Right now, with a relatively low case count nationally, Tolbert said, testing in general isn’t that vital.
But that can always change, and without a major influx of funding from Congress, the uninsured will face huge cost barriers to testing and treatment.
“The biggest issue, and the thing to think about, is what happens if there is another surge.” she said.