FOR THE PAST three years, any sniffle, scratchy throat, or hint of a cough probably led you to get tested for Covid-19. You also might have gotten tested before gathering with friends or family, traveling, or when you found out you’ve been exposed to the virus.
Those tests have mostly been free. But that will change for many people, as the Covid-19 national public health emergency (PHE) ended on May 11.
“From a public health perspective, we certainly hope that these things remain free or very low cost because we know that these are often difficult resources to access,” says Keon Gilbert, Dr.PH, a fellow at the Brookings Institution and associate professor and co-director of the Institute for Healing Justice and Equity at Saint Louis University.
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But whether you can still get a free Covid test will really depend on your insurance status and the type of plan you have.
In March 2020, President Donald Trump declared the national PHE to help fight the Covid-19 pandemic. The declaration made billions of dollars in federal funds available for the public to access Covid tests, treatments, and vaccines for free, and it created other benefits to reduce the impact.
By ending the PHE, the federal government says, “We are now in a better place in our response than at any point of the pandemic and well-positioned to transition out of the emergency phase.”
The Biden administration says it has shipped more than 750 million free Covid-19 tests to 80 million U.S. households via COVIDTests.gov during the PHE. And, 50 million free diagnostic tests were distributed in person at pharmacies and community-based sites.
So, will you have to start paying for Covid tests now that the PHE has ended? Here’s what you need to know.
1. Your Insurance Might Cover Some Covid Tests
Private insurance companies are no longer required to cover Covid-19 tests without cost-sharing after the PHE ends, according to the U.S. Department of Health and Human Services (HHS). That goes for over-the-counter and lab tests.
“Every insurance coverage provider will be allowed to have their own approach to what they will cover in regards to COVID testing,” says Carrie Horn, M.D., chief medical officer at National Jewish Health.
The Biden administration is urging private insurers to continue covering Covid testing, however. UnitedHealthcare said it will cover lab tests ordered by health care providers according to an individual's plan, and OTC tests won’t be covered unless it’s state-mandated. Cigna said it will apply cost-sharing for lab tests, but won’t cover OTC tests.
To know for sure what your insurance covers, Gilbert suggests contacting your insurer or logging into your provider’s website.
If your insurance does cover Covid testing, they might start requiring you to pay a copay or get prior authorization from your doctor.
So your insurance might not cover you to get tested whenever you want, such as before a holiday gathering or traveling.
“I've not seen a ton of data or recommendations, but it does seem to follow a very similar pattern to the ways that people get routine screenings,” Gilbert says.
OTC tests likely won’t be covered directly, Horn says, but you can purchase them if you have a flex-spending health care savings plan.
Medicare will cover Covid lab tests ordered by a health care provider, but there could be a copay, according to HHS. But, it won’t cover OTC tests after May 11.
2. You’ll Have to Pay for Tests If You’re Not Insured
If you’re not insured, you’ll most likely have to pay for Covid tests out of pocket. A two-pack of at-home tests typically costs about $25. Lab test costs depend on the type of test and could range from $90 to $200, Horn says.
Many people—5 million to 14 million, according to the Kaiser Family Foundation—could be finding themselves newly uninsured after losing Medicaid coverage. Early in the pandemic, states were given extra funding to keep people enrolled in Medicaid through the end of the PHE. But, states started using pre-pandemic eligibility requirements in April 2023, and many are being found ineligible.
But state Medicaid programs must still provide coverage for Covid testing without a copay through September 30, 2024, according to HHS. After that, coverage will vary from state to state.
3. You Might Not Be Able to Get Tested for Free Whenever You Want
Until now, you could usually get a free Covid test for any reason through your local health department or other organization. But, the PHE ending will most likely change that.
“It’s likely the case that if you have a clinical indication for a COVID test, and it is ordered by your provider, then insurance companies will cover it similar to any other doctor-ordered test that has a clinical indication,” Horn says.
The exact level of coverage will depend on your insurance plan, however.
If you don’t have Covid symptoms or a known exposure, you’ll most likely have to pay for a test yourself—either an at-home test or a self-pay test at an urgent care or walk-in clinic.
4. You Can Still Get Free Tests Until Supplies Run Out
Free Covid tests will still be provided from the federal government’s stockpile through states and community partners, according to HHS.
You can also still order free at-home tests online until supplies last at Covid.gov/tests.
The Centers for Disease Control and Prevention offers an online tool where you can search for no-cost Covid-19 testing in your area. Gilbert suggests also checking with your local health department or community health centers about free testing.
If you’re stockpiling at-home tests, keep in mind that they do expire and may not be as effective or accurate over time, Horn says.
However, the U.S. Food and Drug Administration has extended the expiration dates for some at-home tests and released a chart for you to check your tests.
5. You Still Need a Covid Test if You Have Symptoms
Even though the PHE is ending and people are mostly not wearing masks anymore, Covid is still out there. So getting tested when you have symptoms is as important as ever to stop the spread.
Any time you’re sick—whether or not you test positive for Covid—you should stay home and isolate yourself from others, Gilbert says. Other respiratory illnesses, like cold and flu, are also floating around and can be spread to others.
Contact your doctor if you have a high fever or difficulty breathing. He says doctors may be able to prescribe Paxlovid or another treatment without you needing to visit the doctor’s office.
