COVID-19 Testing
On-Site Testing
Regardless of who is operating a test site, such as a local government, not-for-profit organization, pharmacy, medical practice, or other private company; always check to find out if the test will be free or covered for you by your health plan with no cost-sharing.
If you’re not sure if your test will be covered, call your health plan at the number on the back of your ID card.
You may be charged or pay out-of-pocket if you receive a test from a provider who is not in your health plan’s network. Confirm reimbursement requirements with your plan before paying for testing.
Yes. COVID-19 testing is offered at no-cost at test sites run by New York State. You can schedule an appointment for testing at a state-run site through the New York State Department of Health's online portal.
You may need to provide personal and insurance information to receive the test, and they may bill your health insurance, but there should be no out-of-pocket costs.
In most circumstances, plans must cover laboratory tests to diagnose COVID-19 as well as the related office visit at medical facilities, including doctor’s offices, urgent care centers, and other outpatient clinics without copayments, coinsurance, or deductibles.
If a provider is in your insurance’s network, they are typically responsible for submitting a claim and can’t bill you directly for covered tests. However, if a provider is out-of-network, you may have to pay up front, then submit a claim for reimbursement.
Yes. Insurers cannot deny coverage of a COVID-19 test from a licensed or authorized health care provider for either of these reasons.
If the test is done exclusively to meet employment requirements, public health research, or for purposes other than for individual diagnosis or treatment, it may not be covered.
Because these limits to coverage exist, some insured consumers may receive bills for COVID-19 testing and related services. Those bills can differ widely from patient to patient.
No. You are not limited to any number of tests to diagnose COVID-19.
Yes. Insurers cannot deny coverage of a COVID-19 test from a licensed or authorized health care provider for either of these reasons.
Seek a free testing site offered by New York State or your local government.
Home Testing
Free at-home, self-tests are available for delivery. Visit COVIDtests.gov to order free at-home, over-the-counter COVID-19 tests. Presently, each household can order four tests.
Yes. Since January 15, 2022, health plans must cover at-home, over-the-counter COVID-19 tests authorized by the U.S. Food and Drug Administration (FDA). Most health plans must cover eight tests per month for each individual covered by your plan.
At this time original Medicare is not required to pay for at-home tests, although some Medicare Advantage plans do cover them. If you have Medicare Advantage check with your plan.
The cost for at-home COVID-19 tests will either be:
- Reimbursed by your health plan or insurer if you have to pay for it up front; or
- Free at the point of scale, if your health plan has an arrangement with the pharmacy or othe retailer.
You should contact your health plan to find out:
- If you need to buy a test and then request reimbursement; or
- If there are "preferred providers" from which yo should obtain tests.
Be sure to keep your receipt if you need to submit a claim to your insurance company for reimbursement.
If your plan does not have a preffered provider:
- Your health plan is required to reimburse you the full amount of the cost of the test—regardless of where it was purchased.
If your plan has a preferred provider:
- You can still obtain tests from other retailers, but you will not be fully reimbursed. Insurance companies are only required to reimburse you up to $12 per test, if you buy them outside of your health plan’s network of preferred retailers.