When the COVID-19 public health emergency ends in the U.S. next month, you’ll still have access to a multitude of tests but with one big difference: Who pays for them.
For the first time, you may have to pick up some or all of the costs, depending on insurance coverage and whether the tests are done at home or in a doctor’s office.
But there’s still time to get some free tests before the May 11 change, and there could still be free ones available afterward. Some state and local governments may continue to distribute free home tests through clinics, libraries and community centers. And the federal government, for now, is still sending free tests through the U.S. Postal Service to households that haven’t already received two shipments.
And don’t discount those old tests you haven’t used. The expiration date on the package may have been extended. The Food and Drug Administration’s website provides a list to check and see which tests are still good.
Here’s a look at what the end of the government’s emergency declaration on May 11 means for testing:
AT-HOME TESTS
The biggest changes will be for over-the-counter tests, which account for the vast majority of screening in the U.S. today.
Since early 2021, the federal government has required all private insurers to cover up to eight COVID-19 tests per month. That requirement will soon go away. Coverage is also scheduled to lapse for tens of millions of seniors in the federal government’s Medicare program, though some members of Congress are pushing to extend the benefit.
While some private insurers may continue to cover all or some home tests, there will be no longer be a nationwide rule. A two-pack of tests typically costs between $20 and $24.
“What we will see is a hodgepodge of approaches by different insurance companies, which is going to make it difficult for individuals to know what they’re going to be paying,” said Christina Silcox, of the Duke Margolis Center for Health Policy, which recently issued a report on the outlook for testing.
One exception will be for those enrolled in the government Medicaid program for low-income individuals and families, who will continue to receive free tests until September 2024.
IN-OFFICE TESTS
Americans can also expect to pay more for any COVID-19 tests performed at a hospital, clinic or doctor’s office.
Insurers have been barred from charging copays, or any other cost-sharing fees related to COVID-19 testing. That requirement also ends next month.
While insurers will still cover basic testing costs, some people could face new fees for a portion of the test’s price or for the services of the health professional performing it. Lab tests have typically ranged between $70 and $100 and some of that could be passed along to patients.
COVID-19 vaccines and drugs will remain free because they are not paid for through insurance, but by the federal government. One concern is that uncertainty around testing costs could lead to delays in treatment. Current treatments for high-risk patients, like Paxlovid, generally need to be taken within the first few days of symptoms to be effective.
If people are worried about testing costs, “they may wait a couple days to see if things clear up and miss that five-day treatment window,” Silcox said.
TESTING CAPACITY
The U.S. struggled to build up its test manufacturing capacity during the first two years of the pandemic, with demand waning after each surge. Experts worry that the country could again be caught flat-footed after the federal government stops purchasing tests in bulk.