What you need to know about the cost of COVID-19 testing and treatment

A new wave of COVID-19 is bearing down on the city, with health experts unsure about what impact it will have.

Many residents are now also facing another new uncertainty: the cost of COVID-related care.

The federal government fund that reimbursed pharmacies, hospitals and other health care providers for the costs of COVID-related care ran dry, without being refilled by Congress.

Since then, many private health providers, no longer able to receive money from the government to cover COVID-19 costs for uninsured people, or costs that may have covered copay fees, have begun charging for such care. Testing at city-run sites remains free.

Reports have begun to fill social media of people being surprised by quotes or charges for PCR tests that have been free for much of the pandemic.

The wave of costs, coming as the omicron subvariant BA.2 is causing a slow rise in infections in the city, has health experts and doctors concerned. Making tests prohibitively expensive, especially for uninsured or underinsured people, they say, will only exacerbate existing health care disparities, and make people less likely overall to seek medical care.

It’s not clear, either, that Congress will provide enough funding to restore the reimbursement program at all, leaving uninsured Americans to pay for testing and treatment at private providers indefinitely.

“It does long-range damage every time someone shows up to get care and gets surprised by a giant bill,” said Dr. Stephanie Woolhandler, a professor of urban public health at Hunter College. “It’s damage for COVID, it’s damage for when the next pandemic comes around, it’s damage when someone has a heart attack.”

Here’s what you need to know about costs of COVID-related care in New

Can a health care provider charge for a COVID-19 vaccine?

No, according to Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation.

Any health care provider or government that agreed to distribute vaccinations has to adhere to federal rules that prohibit charging anyone, with any insurance background, for the shot.

The federal government has already covered the costs of buying the vaccines, as well as shipping them to states, cities and health care providers. The remaining costs associated with administering the vaccines can be billed to either government insurance or private insurance, Tolbert said.

“No entity can charge anyone for the cost of the vaccine, because it’s already been paid for,” Tolbert said.

Does New York City still offer free testing, vaccination and treatment for COVID-19?

PCR testing for COVID-19 is free at all city-run providers, including the NYC Health and Hospitals Network and Gotham Health clinics. For a list of locations and hours, including regular rapid test pick-up locations, click here.

If you test positive for COVID-19 and experience symptoms, you may be eligible for free treatment, provided and delivered by the city. The call line to sign up for the treatment is open from 9 a.m. to 9 p.m., seven days a week, at 212-COVID19.

If I have Medicaid or Medicare, can I be charged for COVID-related treatments?

If you are on Medicaid, you should be able to get tested, treated and vaccinated for COVID-19 for free, Tolbert said.

“People on medicaid should not face any costs for these services,” Tolbert said.

People on Medicare, the government insurance for people aged 65 and up, should not face costs for COVID testing, but may face cost sharing, such as copays, for COVID treatment, such as when they are admitted to a hospital or visit a doctor, she said.

Can I get rapid tests with insurance?

Private insurers are required to cover up to eight rapid tests per member per month. This policy does not apply to people with Medicaid or Medicare Advantage, according to the Kaiser Family Foundation. Insurers, however, are allowed to cap reimbursement for tests at $12 per test; some pharmacies are selling tests for double that amount or more.

If you have an HSA or FSA spending account: According to the Internal Revenue Service, rapid tests (as well as masks and some other protective equipment) are eligible for reimbursement through such programs. Call your particular program to confirm the reimbursement process.