COVERAGE FOR COVID-19 TESTING
Are COVID-19 tests covered?
During the public health emergency, eligible COVID-19 tests will be covered
and FHCP will waive out-of-pocket costs for copays, coinsurance, and deductibles
for these tests, but the following conditions must be met:
- Test must be medically necessary, rendered in accordance with Center for
Disease Control (CDC) guidelines, and ordered by a healthcare provider
licensed to order COVID-19 tests
- Test must be an FDA-approved, emergency use authorized, or authorized under
other guidance from the Secretary of the Department of Health and Human
Services consistent with the federal Coronavirus Aid, Relief, and Economic
Securities (CARES) Act
- The test must be processed in accordance with FDA and other applicable guidance.
Pursuant to CDC guidelines and other applicable guidance, tests performed
on those who have not exhibited symptoms or known to have been exposed
to a person who has tested positive will not be covered. You will be responsible
for the entire cost of the test and any related services.
Which types of COVID-19 tests are covered?
The tests below are covered by FHCP only if the above conditions are met:
- Diagnostic tests (including self-administered or home test kits)
- Antibody or serology tests when used for diagnostic purposes.
Will I have to pay a copay for a COVID-19 test?
During the federal public health emergency, you do not need to pay a copay,
coinsurance or deductible for tests that are ordered by a healthcare provider
as medically necessary because:
- You have symptoms of COVID-19
- You know you were exposed to someone who has COVID-19
- The test is otherwise medically necessary for your situation
This waiver of out-of-pocket testing cost share is only available during
the federally declared public health emergency.
For all other circumstances, you will be responsible for the full cost
of the test.
Information in this post was accurate at the time of its posting. Due to
the fluid nature of the COVID-19 pandemic, scientific understanding, along
with guidelines and recommendations, may have changed since the original