Free trials? As COVID surges, quick results cost up to $300

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By Ana B. Ibarra, CalMatters

When Lakewood’s Rebecca Santucci learned that her sister, Stacy, may have been exposed to COVID-19, she went in search of a rapid test. She needed to know quickly if their 88-year-old father was at risk.

Pharmacies had been eliminated from home testing kits and testing clinics were booked for at least two weeks. On Amazon, she found a set of two at-home tests for $38, but they won’t arrive until next month. And anything that required hours of waiting wouldn’t work for her sister, who suffers from Down syndrome and anxiety.

Eventually, she found a spot for a rapid antigen test at a private drive-thru clinic on the Town of Lakewood’s website. But that was five days after Stacy learned of her potential exposure.

The price of the test: $129.

“We ended up paying the money, but it killed me doing it,” Rebecca said. Stacy tested negative, so at least they finally had peace of mind.

With the explosion of the highly transmissible variant of omicron, more and more Californians find themselves seeking tests wherever they can find them. National and local testing sites are offering free COVID-19 tests, but they’re overwhelmed, forcing people to seek out private pop-up clinics.

Rapid results often come with high upfront costs: some clinics charge nearly $300 for a rapid PCR test.

Although state and federal regulations require COVID tests to be free or covered by health insurance, people often have to pay up front, and the amount is unaffordable for many Californians.

Those who cannot afford to pay will often have to queue for hours at local and national free testing sites, then sometimes wait days for lab results.

“There is a requirement that the tests be free, but there is no requirement as to how quickly those test results must be returned,” said Shira Shafir, professor of epidemiology at UCLA. “With this omicron push, some people are again waiting four to five days for those lab results and at this point those results are essentially useless.”

In addition to asking for quick results, some places require proof of testing within 24 to 72 hours. People need it to visit nursing homes and retirement homes, return to daycare programs, or board flights to Hawaii or overseas.

California international airport pop-up sites charge in advance. At San Francisco International Airport, a rapid test costs $275. At Los Angeles International Airport, a rapid PCR test with results within an hour costs $199. According to a LAX provider, Clarity Mobile Venture, debit or credit card payments are required, although a receipt is provided for insurance reimbursement. At San Diego International Airport, the cost is $135 to $165, and at Long Beach Airport, a test with 1.5 hour results costs $250.

At the Lakewood clinic Santucci visited, costs range from $129 for a rapid antigen test with results in one hour to $299 for a PCR test with results in two hours. The clinic also advertises a free standard PCR test with results in two or more days.

“With rapid tests, what people may be paying for is the guarantee of rapid results,” Shafir said. “The test site doesn’t always present it that way.”

Both PCR and antigen tests are used to diagnose COVID-19; antigen tests may give faster results, but PCR tests are more sensitive to detecting the virus, so they are considered more accurate.

Health experts say getting results quickly is key to protecting people and avoiding lengthy quarantines, but rapid tests have long been in short supply.

Keep your receipts

Californians have an array of places where they can be tested: a hodgepodge of pharmacies, community clinics, government mass testing sites and private pop-up sites. Many of them are free, but they are reserved for weeks. Some popup testing sites charge in advance, which creates confusion as to why, since testing is supposed to be free.

In most pharmacies and doctor’s offices, providers do not bill people directly. Instead, they collect insurance information so they can get paid. But some private screening clinics charge individuals, who are then responsible for obtaining reimbursement from an insurer. Claims can be filed online or sent to the insurer by mail.

But that’s not always a guarantee that they’ll get their money back.

Stacy Santucci is covered by Medicare, which covers people with disabilities. Rebecca said she did not receive a receipt after her sister’s test, but did receive an email confirmation from the testing provider, Covid Clinic. When Rebecca called her sister’s health insurance plan, she was advised to print the email and send it by post, but there was no guarantee that she would be reimbursed because the e- printed mail might not be enough.

Experts recommend checking receipts for additional service charges, such as a fee for expedited results.

Charging extra fees for quick results is misleading, said state Sen. Richard Pan, a Democrat from Sacramento, who last year drafted a bill, SB 510, that clarifies the rules around free testing. . The law, which took effect Jan. 1, codifies federal rules into state law, requiring insurance companies to cover testing without any cost sharing such as copays or deductibles.

Pan said his office is reviewing cases of providers who add extra fees to a test — they will provide a procedure code for the test itself which patients can then submit to their insurer for reimbursement, but they will not provide a procedure code for the test itself. repayment. code for the mysterious supplement.

“Trying to splice the bill in a way that continues to cost the patient is definitely not within the spirit of the law,” Pan said.

The law also does not address the issue of having to pay upfront. The challenge is that new testing sites typically don’t have existing relationships with insurers, so they charge the individual instead, Pan said.

“They (testing clinics) just want to be paid, for them, no matter where that payment comes from,” Shafir said.

Throughout the pandemic, the trend has been that those with fewer resources are less likely to access testing.

Upfront costs and long lines can deter people from getting tested and worsen health disparities, experts say. People without insurance do not have the option of requesting a refund. And the tests require free time or flexible work, and sometimes the physical ability to wait in line or own a car.

State reviews complaints

The California Department of Public Health told CalMatters in an unsigned email that it is aware of the complaints about the pop-up sites, including concerns about business practices related to pricing, but also the test validity and specimen handling.

The health department is urging residents to look for verified testing sites on its website where there are no reimbursable fees, regardless of their insurance status.

Eddie Daniels administers rapid COVID-19 tests at Greater St. Paul’s Church in downtown Oakland on January 4, 2022.Martin do Nascimento / CalMatters

In recent press conferences, Governor Gavin Newsom touted the more than 6,200 verified testing sites in the state. About 90% of Californians are within a 30-minute drive of a verified testing site, according to the state health department.

“While that’s impressive, we recognize that it’s not good enough, nor is the fact that there are lines appearing on sites like this all over the state,” Newsom said Wednesday from a testing location at Paramount.

In response, Newsom brought in the National Guard to help administer the tests and introduced a $2.7 billion COVID relief package that includes dollars to increase capacity, staff and hours at the sites of testing, as well as to increase the number of COVID-19 antigen tests sent to local health departments, community clinics, and county offices of education and schools.

Testing sites will likely be in high demand for several more weeks, especially as home testing kits are still hard to come by.

For those who can find home testing, a new state order will add protections for what they pay. Newsom signed an executive order to protect people from price gouging for home test kits. The order prohibits the sale of test kits for more than 10% of the price the seller charged on December 1. New sellers cannot charge more than 50% of what they paid for the test kit.

Starting Saturday, a new federal rule will allow people who purchase at-home tests to be reimbursed by their insurer for up to eight at-home coronavirus tests per person per month. Again, the trick is to find these tests.

Additionally, U.S. residents can order free rapid home coronavirus tests online at COVIDTests.gov starting Wednesday. Tests will ship 7 to 12 days later, according to federal officials.

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