During the pandemic, the government pledged to make COVID-19 testing free and accessible to insured and uninsured patients. While community-based testing sites and insurers cover many costs, the NBC 5 Responds team still found a wide range of charges and circumstances that leads to billing confusion for patients.
Luis Correa of Dallas says he paid $500 out of pocket for a rapid COVID-19 test in June after feeling like he was out of options and desperate for answers.
Correa says when he came down with a fever, chills and itchy throat, he went to an urgent care clinic where his insurance covered the cost of a COVID-19 test. He says he was told to expect results in two or three days, but the results were delayed. Correa, who was trying to isolate from close family, says he needed fast answers.
“My partner has some health conditions. My mother has major underlying health conditions and she depends on me for a lot of things,” said Correa.
“I'm afraid I'm going to get a lot of people sick,” Correa added. “I know that I need to find out either a positive or a negative.”
Correa went to a freestanding emergency room where he paid $500 for a same-day, rapid COVID-19 test. The test showed he was positive for COVID-19.
“Thankfully, I have the resources to be able to pay $500 for a test, but there are the people that don't have that. There are people that are struggling to even get a test,” Correa said.
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Federal law requires COVID tests and related office-visit costs to be covered by insurance companies in a cost-sharing measure during the pandemic.
Correa says his insurance covered his first test, but the test at the freestanding emergency room was not covered.
Dr. James Pinckney of Diamond Physicians, who is not involved in Correa’s care, says he charges no more than $150 for the same rapid COVID-19 test.
But Pinckney explains that’s the price at a doctor’s office, not an emergency room.
“At an ER, prices are always going to be more expensive,” Pinckney told NBC 5. “As long as they’re being forthcoming with the price and not telling the patient afterwards: it’s 500 bucks cash, I don’t have a problem with that.”
“I’ve got numerous colleagues that own freestanding ERs and that’s about what they’re charging,” Pinckney added.
Correa visited the Trusted ER location in Uptown. Dr. Harvey Castro, President of Trusted ER, says it is transparent about the cost of the rapid test.
Castro says the price reflects the ER’s higher overhead and the convenience of taking patients without appointments, 24 hours a day, seven days a week.
“The difference is we’re open 24/7. We’re doing the test right there, you’re seeing a doctor, a nurse, getting a full evaluation,” said Castro.
Castro also says the ER offers more affordable testing options, including a mobile testing unit that visits businesses where employers can arrange for employee testing.
Correa says, as a patient, he felt that he was left with few choices.
Correa said he could wait for lab test results that ultimately took eight days. Or, pay a premium for a timely answer.
Correa says more should be done to ensure tests can be processed in the promised window.
“Having gone through it and I'm still going through it, it puts your mind in a different perspective or seeing things in a different way. It makes you realize that the system is failing us. It really is,” said Correa.
NBC 5 Responds reached out to a handful of insurance companies and providers about COVID-19 testing costs and what you should know in case you’re charged.
If you believe you have been incorrectly billed, file an appeal or call your insurance company to find out what’s covered – especially if you sought treatment or testing in the early days of the pandemic.
CareNow says any patient responsibility, including copays, coinsurance and deductibles, collected for a visit that results in a COVID-19 test will be refunded once a claim is processed by the insurance company.
Blue Cross and Blue Shield of Texas says it is temporarily waiving member cost-sharing, including deductibles, copayments and coinsurance, for COVID-19 testing and in-network testing-related visits and treatment.
According to Aetna, patients should not have any out-of-pocket costs with their insurance. Uninsured patients will be covered under a Department of Health and Human Services program. It also supports community-based sites to conduct free rapid tests, including Mercy Clinic in Fort Worth.
Methodist Health System, on its website, reports: insured patients may be covered for testing without paying a deductible or coinsurance. Uninsured patients may qualify for testing coverage during the public health emergency.
For health care providers who test uninsured patients, the federal government launched the COVID-19 Uninsured Program Portal. Providers who conducted testing or treatment on or after February 4, 2020 can submit claims for reimbursement.
If you or someone you know have paid an outrageous amount for testing, a hospital stay or something else related to the pandemic, we want to hear from you. Please email us at NBC5Responds@nbcdfw.com