After the COVID-19 Public Health Emergency Ends on May 11, Some Consumers Could Face High Prices for COVID-19 Testing

After the general public well being emergency ends on Would possibly 11, personal well being plans will now not be required to hide the entire price of COVID-19 exams ordered or administered via a clinician or to reimburse customers for at-home speedy exams.

To estimate what customers may need to pay for exams, KFF’s new analysis attracts on claims knowledge appearing what personal insurers have paid for several types of COVID-19 exams, in addition to hospitals’ revealed “self-pay” costs for sufferers with out insurance coverage and a survey of main outlets’ costs for at-home COVID-19 exams. What customers pay is dependent upon their insurance coverage plan or whether or not they’ve insurance coverage in any respect.

The research unearths the median worth of a COVID-19 check in an outpatient scientific atmosphere was once $45 amongst folks with massive employer-based well being protection in 2021, despite the fact that costs various broadly. Normally, antigen trying out was once inexpensive than PCR trying out, with a mean worth of $42 for antigen trying out in comparison to $62 for PCR trying out. Along with the price of the COVID-19 check itself, there is also an extra rate for the related place of business talk over with relying on price sharing preparations, which is able to moderate about $90 for folks with personal medical health insurance. In combination, the cost for a COVID-19 check in a scientific atmosphere and the related talk over with may cross as much as $150 if a deductible applies.

The median “self-pay” worth for any individual with out medical health insurance at a health center or outpatient atmosphere is $51 for a COVID-19 antigen check and $91 for a PCR check. Costs for a COVID-19 PCR check at a health center additionally range broadly via state and are most costly in Alaska, with a mean self-pay worth of $200, and least pricey in Utah, with a mean self-pay worth of $41.

The research additionally unearths that almost all at-home speedy exams price between $12 and $24 in keeping with pack (the cost in keeping with check averages $11). Non-public insurers will now not be required to hide the price of those exams as soon as the general public well being emergency ends.