As the COVID-19 public health emergency comes to an end in the U.S. next month, changes in testing procedures and costs are on the horizon. Starting May 11, individuals may have to bear some or all of the costs of COVID-19 tests, depending on their insurance coverage and whether the tests are conducted at home or in a doctor’s office.
However, there are still opportunities to obtain free tests before the changes take effect, and there may continue to be free testing options available even after May 11. Some state and local governments may still distribute free home tests through clinics, libraries, and community centers. Additionally, the federal government is currently sending free tests via the U.S. Postal Service to households that have not yet received two shipments.
Don’t overlook any unused tests you may have. It’s possible that the expiration date on the package has been extended. The Food and Drug Administration’s website provides a list of tests that are still viable.
Let’s take a closer look at what the end of the government’s emergency declaration on May 11 means for testing:
AT-HOME TESTS
The most significant changes will occur with over-the-counter tests, which account for the majority of screening in the U.S. Currently, private insurers are required to cover up to eight COVID-19 tests per month. However, this requirement will no longer be in place. Coverage is also set to expire for millions of seniors under the Medicare program, although some members of Congress are advocating for an extension.
While some private insurers may continue to cover all or some home tests, there will be no nationwide rule. Typically, a pack of two tests costs between $20 and $24.
“What we will see is a variety of approaches by different insurance companies, making it challenging for individuals to anticipate their expenses,” explained Christina Silcox of the Duke Margolis Center for Health Policy, which recently published a report on testing outlook.
However, individuals enrolled in the government Medicaid program will still receive free tests until September 2024.
IN-OFFICE TESTS
Expect an increase in costs for COVID-19 tests conducted at hospitals, clinics, or doctor’s offices.
Currently, insurers are prohibited from charging copays or other cost-sharing expenses related to COVID-19 testing. However, this requirement will end next month.
While insurers will still cover basic testing costs, patients may face additional fees for a portion of the test’s price or for the services of the healthcare professional conducting it. Lab tests typically range between $70 and $100, and some of these costs could be passed on to patients.
It’s important to note that COVID-19 vaccines and drugs will remain free, as they are not paid for through insurance but by the federal government. However, concerns arise regarding potential delays in treatment due to uncertainty surrounding testing costs. Current treatments for high-risk patients, such as Paxlovid, are most effective when taken within the first few days of symptoms.
“If people are worried about testing costs, they may wait a couple of days to see if things improve and miss the five-day treatment window,” Silcox warned.
TESTING CAPACITY
During the first two years of the pandemic, the U.S. faced challenges in building up its test manufacturing capacity, with demand declining after each surge. Experts worry that the country may find itself unprepared again once the federal government stops bulk purchases of tests.
Stability in production was achieved only after the U.S. government committed to buying 1 billion tests, resulting in a peak of 900 million monthly tests in February 2022.
“These bulk purchases essentially guaranteed a market for test manufacturers,” explained Jennifer Kates, a senior vice president with the nonprofit Kaiser Family Foundation.
According to researchers at Duke, manufacturers were still producing over 400 million tests per month as of September, a number that exceeds current testing levels in the U.S.
Companies like Abbott Labs claim they will be able to scale up test production as needed, but specific production targets and the impact of the end of the health emergency remain unclear.
Congress has shown limited interest in buying more tests, and the Biden administration did not propose additional spending in its latest budget.
“The absence of the upfront guarantee by the federal government to handle testing volatility will be felt,” Kates added.
TESTING TECHNOLOGY
The hundreds of COVID-19 tests authorized by the Food and Drug Administration in the past three years will still be available after May 11. This is because the FDA approved these products under a separate emergency measure that is unaffected by the end of the national declaration.
However, the FDA encourages test manufacturers to apply for full regulatory approval, which would allow their products to remain on the market indefinitely. Last month, the FDA granted formal approval to the first rapid COVID test.
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