Out-of-pocket COVID-19 test costs piling up

Get tested is the mantra, but it’s not always free

OVER THE LAST two months, Aaron Zannini has faced a COVID crunch – waiting hours in line for four precautionary coronavirus tests at Carewell Urgent Care centers in Cambridge and Somerville that ended up costing him a total of $640.

Zannini is part of a growing group of people who aren’t symptomatic but want a test because they’re traveling for the holidays, returning from college, or just want to reassure grandma and grandpa.

Under existing rules, their insurance won’t cover the cost of a test unless the person is symptomatic or the test is ordered by a doctor or contact tracer. Usually that’s if someone has been near a person who tested positive for COVID-19. The free test sites run by the state tend to be overrun with people; Zannini said the nearest free-testing site to him couldn’t take him for 5 to 10 days.

Zannini said he was able to pay part of his testing bill with a health finance card, but without that he would not have been able to cover the cost. He said many others are probably not as lucky.

“It’s a shame that people are potentially not getting tested because they have to incur this huge financial burden in the middle of this pandemic,” he said. “Everyone’s like, get tested, get tested, it’s covered, it’s covered and then you get there and they’re like, ‘It’s $160, please.’ It kind of catches you off guard.”

Free testing is available at the state’s 18 Stop the Spread sites, but they are often very busy and several parts of the state, including Cape Cod and north-central and western Massachusetts, are uncovered. Residents on the Cape, for example, would have to drive to New Bedford for the nearest free-testing site. In places with high infection rates, like Brockton, cars of people are being turned away after waiting several hours for a test.

The free testing sites are generally located in communities hard hit by COVID-19, including Brockton, Chelsea, Everett, Fall River, Framingham, Holyoke, Lawrence, Lynn, Marlborough, Methuen, New Bedford, Randolph, Revere, Salem, Saugus, Springfield, Winthrop, and Worcester. There’s also a drive-thru site in Revere.

In Arlington, Bob Carter wanted to test for the virus before traveling to his daughter’s wedding in North Carolina. Everyone else at the small affair was getting tested, and he wanted to be safe.

Carter got a $175 rapid test at an AFC urgent care facility last Wednesday. “Basically, I was told the insurance wouldn’t cover it so I just agreed to pay it out of pocket,” he said.

Carter thinks tests for asymptomatic individuals, and those traveling and needing tests, should at least be subsidized, because the state has imposed coronavirus-related travel restrictions. “I definitely think it should at least be partially covered,” he said.

The costs of tests can vary significantly. AFC and Carewell urgent care sites, for example, pay $110 for the Quest Diagnostic laboratory tests they administer. Carewell charges patients $160 for the tests, while AFC charges anywhere from $150 to $260. AFC’s website also lists the price of $219 for rapid COVID-19 testing. The organization didn’t respond to inquiries about the range of prices.

Zeeshan Sheikh lives in the Greater Boston area and tried calling a free testing site in Framingham but wasn’t able to reach anyone. He was considering Carewell for $160, but heard the turnaround time was slow. So he went to AFC Urgent Care in Arlington and paid $259 for a test on October 6.

“I knew the Carewell cost and thought AFC would be the same, but I did not know that AFC was going to be $99 more for the same Quest Diagnostics test,” Sheikh said.

A sign indicates long lines outside of Carewell’s Urgent Care Center in Inman Square, Cambridge. (Photo by Sarah Betancourt)

CVS is advertising 4,300 testing locations “at no cost to you,” but there is a catch. Symptomatic patients or those who have a doctor mandated test and have come in contact with a person who has COVID-19 are the only ones actually covered. CVS requires a health insurance card for anyone who has one; for those without one, a social security number, state ID, or driver’s license must be shown so that the cost of the test can be submitted to a federal program for the uninsured. The test, CVS’s website says, is $139, which includes $100 for an independent laboratory to process the test, and $39 for a MinuteClinic visit.

Media representatives from the three largest medical insurance providers in the state – Harvard Pilgrim Health Care, Tufts Health Plan, and Blue Cross and Blue Shield of Massachusetts – all say their companies follow state and federal guidelines for insurance coverage, which means covering only symptomatic individuals and those whose doctors have ordered testing.

At Blue Cross, the company “waived member cost share (co-pays, co-insurance, and deductibles) for medically necessary COVID-19 tests,” according to a spokesperson. Harvard Pilgrim does the same.

 A spokeswoman for Harvard Pilgrim said the company’s records indicate the average cost of a COVID-19 test is $111, but the price can run from as low as $30 and as high as $500.

The COVID-19 Command Center said the answer to what determines insurance coverage is not “that cut and dry” and that there are many factors that play into the decision. Those are: that the state is discouraging travel, some cities and towns are offering municipal-sponsored free testing, and some employers occasionally offer testing programs to their employees.

“COVID-19 testing for symptomatic individuals and close contacts is covered by insurance and available at no cost,” said a spokesperson for the Command Center.

Meet the Author

Sarah Betancourt

Reporter, CommonWealth

About Sarah Betancourt

Sarah Betancourt is a long-time Latina reporter in Massachusetts. Prior to joining Commonwealth, Sarah was a breaking news reporter for The Associated Press in Boston, and a correspondent with The Boston Globe and The Guardian. She has written about immigration, incarceration, and health policy for outlets like NBC, The Boston Institute for Nonprofit Journalism, and the New York Law Journal. Sarah has reported stories such as a national look at teacher shortages, how databases are used by police departments to procure information on immigrants, and uncovered the spread of an infectious disease in children at a family detention center. She has covered the State House, local and national politics, crime and general assignment.

Sarah received a 2018 Investigative Reporters and Editors Award for her role in the ProPublica/NPR story, “They Got Hurt at Work and Then They Got Deported,” which explored how Florida employers and insurance companies were getting out of paying workers compensation benefits by using a state law to ensure injured undocumented workers were arrested or deported. Sarah attended Emerson College for a Bachelor’s Degree in Political Communication, and Columbia University for a fellowship and Master’s degree with the Stabile Center for Investigative Journalism.

About Sarah Betancourt

Sarah Betancourt is a long-time Latina reporter in Massachusetts. Prior to joining Commonwealth, Sarah was a breaking news reporter for The Associated Press in Boston, and a correspondent with The Boston Globe and The Guardian. She has written about immigration, incarceration, and health policy for outlets like NBC, The Boston Institute for Nonprofit Journalism, and the New York Law Journal. Sarah has reported stories such as a national look at teacher shortages, how databases are used by police departments to procure information on immigrants, and uncovered the spread of an infectious disease in children at a family detention center. She has covered the State House, local and national politics, crime and general assignment.

Sarah received a 2018 Investigative Reporters and Editors Award for her role in the ProPublica/NPR story, “They Got Hurt at Work and Then They Got Deported,” which explored how Florida employers and insurance companies were getting out of paying workers compensation benefits by using a state law to ensure injured undocumented workers were arrested or deported. Sarah attended Emerson College for a Bachelor’s Degree in Political Communication, and Columbia University for a fellowship and Master’s degree with the Stabile Center for Investigative Journalism.

Gov. Charlie Baker is a huge proponent of testing, and often says the state has one of the highest per-capita levels of testing in the nation. Over the last seven days, an average of 87,666 tests were administered each day, with the high point – 110,239 tests – on Sunday.

The governor says the much higher testing levels during this second surge are generating a lot more positive results. He estimated the state was catching 1 of every 15 to 20 cases in the spring with the lower testing levels then. Now, with higher testing levels, he said the state is catching 1 of every 4 cases.