Buzz
You shouldn’t receive a bill for your coronavirus test. However, as many who have dealt with surprise medical bills will tell you, just because you don’t anticipate being charged doesn’t mean it won’t happen.
So, what steps can you take to avoid ending up with an unexpected bill?
First, remember that the recent legislation covers testing and care related to coronavirus diagnosis. The Families First Coronavirus Response Act ensures that all COVID-19 tests are paid for by either your insurance or the government. Additionally, the CARES Act extends this protection, mandating that health plans reimburse providers for related services, even if they fall outside the patient’s network.
Don’t skip necessary medical care because you’re concerned about the costs, advised Caitlin Donovan, a representative for the nonprofit Patient Advocate Foundation.
If you do receive a bill for your care, she offers advice on how to manage the situation.
Errors in medical billing are quite common.
You may have heard about some of the worst-case scenarios where patients ended up with a bill for coronavirus-related services:
CNET interviewed a woman from Colorado who shared that while her insurance covered her coronavirus test, it did not cover the expenses for the emergency room visit prompted by her symptoms.
In another case reported by NPR, a woman from West Virginia had to be tested for other conditions to rule out alternatives due to the limited availability of COVID-19 tests. After testing positive for influenza B, she was left with a $500 bill, even after insurance.
According to NPR, this type of situation is not unusual. Some healthcare providers may need to test for other illnesses before administering a COVID-19 test, which could result in patients being billed for additional tests or office visits.
This means it’s your responsibility to confirm any potential costs before seeing a healthcare provider—which can be incredibly stressful when you're already not feeling well, right?
Do your research before seeking medical care.
The first way to avoid unexpected charges is to ensure you're following the correct procedures. This includes checking the requirements for testing centers (some may require a doctor's order) once you've found options near you.
If you have insurance, the ideal time to learn about your coverage is before you're feeling unwell. But, with the high demand and long wait times on the phone, we’re guessing that hasn’t happened yet.
If you're feeling sick, start by checking your insurance provider's website—Donovan mentions that most carriers have dedicated pages with coronavirus-related information. Taking a screenshot or printing those pages can be helpful if you need to file an appeal later.
If you need assistance gathering information (and let’s face it, you're probably not feeling great by this point), you can ask a friend or family member to help. Health privacy rules allow your insurer to share plan details with someone calling on your behalf.
Donovan suggests reaching out to your insurance company first, your family or primary care doctor second, and only then directing questions to a large healthcare facility to ensure you’re getting the most useful information.
Don’t rush to settle any medical bills.
If you're getting tested for the coronavirus, you shouldn't be charged a copay or coinsurance, according to Donovan. However, if you receive a bill after your visit, she advises you not to pay it immediately.
Instead, wait for your explanation of benefits (EOB) to arrive either by mail or electronically. Once you receive this statement, it means your insurance has processed your claim, and you can then compare it with your billing statement. 'It should match,' Donovan said. 'If not, there’s been a mistake.' She pointed out that many medical bills contain errors, and given the rapidly changing nature of coronavirus-related care, errors are to be expected in any post-care bills you receive.
Use the appeals process only as a last resort.
That doesn’t mean you won’t have to pay something for your care. If you were tested for conditions like strep or the flu, you might receive bills for those tests. Additionally, if you are diagnosed with coronavirus and need treatment, you could face out-of-pocket costs for some of that care.
However, you should be able to make a strong case for having diagnosis-related care covered. 'If your bill has been processed by insurance and you're still receiving a bill, contact your insurer first. If they confirm you shouldn't be billed, contact the provider,' Donovan advised. The Patient Advocate Foundation offers a guide to navigating the appeals process in case you need to contest a denied insurance claim.
