People going to get tested for the new coronavirus could come away with more than just a diagnosis. They might get a bill, too. This, despite the federal government’s effort to make COVID-19 testing and treatment free for insured and uninsured patients. So why are some people still being charged?
Testing for the coronavirus is a lot more available today than it was a few months ago, but it’s also, from descriptions like Carson Mitchell’s experience, still unpleasant.
“They had this long swab, and they put it up my nose, and they pushed until it reached the back of my throat, and…it was pretty painful," Mitchell said, describing how the test was administered as she and her sister held hands in their car at the drive up testing site at a Patient's First Clinic in Tallahassee.
Tests can now be turned around in a matter of days not weeks. Mitchell and her sister were among the first patients tested by Patients First. They wanted to know if they’d been exposed to the virus. When it was over, Carson’s test was free. Her sister’s wasn’t.
“I have Blue Cross, Blue Shield, a PPO plan. But he said my sister, who has a Blue Cross, Blue Shield HMO plan--it would not be free for that plan. And when I asked about the payment for my plan, he mentioned the federal test all did not require a co-payment," she said.
Mitchell says she was fully prepared to pay for the tests and could have managed the $400 it would have been for the two of them. She was pleased to see testing available for people who don’t have symptoms or a doctor’s referral. But “that comes with the understanding that I have the privilege to be able to pay 175 a pop. If I had to spend $400 that day, I would have been able to without too much stress on my finances, but that’s definitely not to say for everyone in Leon County.”
Free Doesn't Always Mean Free
“We’ve seen reports of a hospital in the city of Hialeah… that’s charging people $150 to be tested for COVID-19. Many of these people are low-income individuals," Gov. Ron DeSantis said during a March press conference.
He asked Florida Attorney General Ashley Moody to investigate a South Florida Hospital for charging for COVID-19 tests and accused the hospital of price gouging. Congress passed a law earlier this year making Coronavirus testing free for people without and with insurance, regardless of the type of plans they have. But as Mitchell and her sister's experience demonstrates, what’s “free” and what’s not isn’t always clear.
“Patients should not have to pay for Covid testing or related treatments, if they test positive. Health insurers are waving all about-of-pocket costs …for their members," said Audrey Brown, CEO of the Florida Association of Health Plans.
She says health plans are supposed to cover the costs of COVID tests and treatments. But that’s not necessarily true for providers, who perform those services. And, there are lots of caveats to the term “free”. In Patients First’s case—it accepts one type of health plan, but not others, leading some people to have to pay.
“There are facilities and providers who don’t have an agreement with the federal government for reimbursement. There are also Floridians without health insurance who want to be tested and are willing to pay cash for the test," said Brown.
She says people should ask for clarification on what test is being given and ask questions, especially if they're asked to pay.
"If you have health insurance, you are covered. If you do not have health insurance, you can still get a free test by finding a government sponsored testing site in your area, instead of going to a doctor, lab or hospital that wants to charge you for this test.”
Brown says she’s seeing another issue begin to emerge: some providers are sending bills to insurance companies that she calls “outrageous.” And, she warns of something new—testing fraud. Though Brown didn’t note any specific examples, she says she’s received calls about groups popping up in South Florida purporting to be testing for COVID-19, but not submitting those tests to labs for verification.
