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When You Will Have To Pay For A Coronavirus Test In Mass. And Why

A Chelsea resident is being directed by a health care worker before inserting a swab up her nose during free COVID-19 testing offered by the state in Chelsea Square. (Jesse Costa/WBUR)
A Chelsea resident is being directed by a health care worker before inserting a swab up her nose during free COVID-19 testing offered by the state in Chelsea Square. (Jesse Costa/WBUR)

As of now, Massachusetts expects health insurers to pay the full cost of a coronavirus diagnostic test in three cases:

  1. You have symptoms
  2. You’ve been in close contact with someone who has tested positive
  3. You must be tested before being admitted to a hospital or clinic

The Baker administration says it has no plans to change these criteria, even though the CDC now says people who’ve been in close contact with someone who is positive “do not necessarily need a test.”

“While we are reviewing this changed federal guidance, it is not anticipated that any immediate changes will be made to the current testing protocols,” said Tory Mazzola, the state’s COVID-19 Command Center spokesperson.

Insurers, both private plans and MassHealth, are not paying for diagnostic tests so you can:

  1. Travel
  2. Return to work
  3. Start school, day care or an internship
  4. Visit someone in a hospital, rehab facility or nursing home or someone who is at home and is high risk
  5. Accompany someone for a medical procedure

If you want or need a test for one of these reasons, you can get a free test at one of the state’s Stop the Spread sites. These sites, in communities with higher infection rates, are only open to Mass. residents. They’re funded with a combination of state and federal dollars.

Some employers offer free tests for employees returning to the office or coming back from a trip.

If you can’t get a free test through your employer or a Stop the Spread site, some urgent care clinics offer tests for anyone. Check their websites for details. Others limit tests to people with symptoms or their close contacts.

I called two of the state’s larger urgent care networks to ask how much a test would cost. After an hour on the phone, I still don’t have firm answers, but here’s what I have:

  1. You may be billed for both the office visit and the test. That package could range from $140 to more than $300, although there are reports of much higher bills.
  2. Your cost will be lower if the clinic charges you the rate your insurer would pay. Ask to pay the rate your insurer has negotiated for the visit and test.

We’d love to hear your stories about paying for a coronavirus test, you can leave a comment below or email me at marthab@bu.edu. And keep in mind, testing and lab capacity is still limited in some areas so public health leaders ask that you only get tested when needed.

Related:

Martha Bebinger Twitter Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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