How has the CARES Act affected Covid-19 testing prices? How about rapid testing prices? If you’re in a hurry to get tested, you probably want to know which tests are free!
In March of 2020, we got our first iterations of the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. With these, the government has required health coverage for Covid-19 testing at no cost, as well as made federal dollars available to assist pay for free testing for uninsured individuals.
You may be wondering: Are Rapid Tests Covered By The CARES Act?
The answer is: it depends.
First things first, what do we mean by rapid?
When you hear someone mentioning a “rapid test,” they’re likely referring to Rapid Antigen tests. Earlier in the pandemic, Rapid PCR tests weren’t available as often. Since this phrase was most used for 15-min Antigen tests, many of us now say ‘rapid test‘ as a colloquial term for Rapid antigen tests.
But, by now, most of us are well aware that Antigen diagnostic tests aren’t as reliable as PCR tests. As we’ve mentioned time & time again, PCR tests are the gold standard of Covid-19 testing. and many looking for rapid tests also want the most trustworthy results possible.
Now that expedited PCR testing options exist, a Rapid Covid-19 test could also refer to an expedited, or rapid, PCR test.
What are the differences in Rapid Antigen & Rapid PCR tests?
These are both diagnostic tests, and they can both be rapid.
So, what are rapid diagnostic tests? How do they work?
Rapid diagnostic tests include Rapid Antigen tests and Rapid—or expedited—PCR tests. Because of the nature of molecular PCR and antigen testing protocols, PCR tests will generally cost more.
Keep in mind: Antigen tests are, by nature, rapid. They test for proteins that are more easily detected. Generally, you’ll receive results within 15 minutes or less regardless of where you’re tested. PCR tests, on the other hand, require additional or alternative lab equipment to be performed more quickly. They’re more expensive than Antigen tests to perform, even without the equipment required for expedited/rapid results.
So, Rapid PCR tests will be more expensive than Standard PCR tests—and both of these will be more expensive than a Rapid Antigen testing option.
But, how does this play into the CARES Act & Covid testing coverage? Well, from the patient’s perspective—not much at all!
The CARES Act codifies this in law—requiring insurance to cover the full price of diagnostic testing they currently provide for free.
This means that patients will not be charged extra for rapid or PCR genetic tests. If they are covered by Medicare/ACA/private insurance, there is no cost—aside from expedited fees at the patient’s discretion.
Which Rapid Tests Are Covered By Insurance?
In early 2020, the Federal government required insurers, Medicaid, & Medicare to cover Covid-19 tests. The specifics as to when they were or weren’t covered weren’t clarified—however.
For the most part, any insured individual can have their Covid-19 test covered after these legislative efforts. In its early enactment, it was mostly applied to patients who showed symptoms or had been near others infected with Covid-19. In early 2021, federal guidance cleared up previous confusion. Now, even asymptomatic individuals should have their tests covered by insurance, Medicare, or Medicaid.
There’s one circumstance in which insurance doesn’t need to cover a Covid-19 test: when administered in groups for employee back-to-work programs or public health surveillance reasons.
Which Tests Are Covered By The CARES Act?
The simple answer is: All of them! Diagnostic tests like Rapid Antigen and PCR tests as well as Antibody should be covered by insurance.
Outside of the Medicare system, there is currently no federal control over COVID-19 diagnostic test pricing. Hospitals and labs may charge whatever they choose for privately insured and uninsured individuals, just like with other medical treatments. Private health insurance companies negotiate rates with hospitals and providers that are part of their network.
Insurers have to pay the provider’s “list price” for testing and related services when people are out of network.The CARES Act stipulates that providers make the cash price available to insurers on their public webpages. During the existence of a public health emergency, such as an epidemic or pandemic threat, insurance companies must comply with CARES Act requirements and pay claims on your behalf.
How Do I Know if I Qualify?
Here at Alliance, your insurance or CARES Act will cover our Same-Day PCR test, Rapid Antigen Test, & Rapid Antibody Tests.
Congress indicated its intention to eliminate cost obstacles for COVID-19 testing for patients, whether they are insured or not, with the FFCRA and CARES Act. While the Biden Administration has made it clear that all testing for diagnostics, including those who are asymptomatic and do not require medical screenings, must be covered, there are still instances in which patients may be charged for tests. At Alliance, we’re always available to help ensure your test is covered—whether by insurance or the CARES Act!
If you’re looking to get tested and still confused about coverage, give us a call at (844) 678 – 0055 & we’ll answer your questions!
Get PCR results for free on the very same day in our Miami Beach clinic. Or give us a call, & we’ll come to you!