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Cuomo Orders Health Insurers To Waive Coronavirus Testing Fees
By
Caroline Lewis
Published Mar 3, 2020
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Don Pollard / Governor's Office
By
Caroline Lewis
Published Mar 3, 2020
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We may not have drive-through screenings for COVID-19 like the ones that have popped up in some cities in South Korea, but getting tested for the disease in New York is about to become much more accessible to those who have reason to believe they might be infected. Unlike the rest of the country, most New Yorkers won’t even have to worry about what it costs.
Governor Andrew Cuomo announced Monday evening that the state Department of Financial Services had issued a directive requiring private health insurers in New York to make coronavirus testing free for patients by waiving any out-of-pocket costs they would typically have to pay.
This includes any fees associated with an emergency room visit or a visit to an in-network health care provider for the purpose of getting tested for COVID-19. Medicaid enrollees will also be able to get tested for free.
Cuomo’s announcement comes as the state and city are making efforts to quickly ramp up their capacity to test for the disease, which has caused some 3,000 deaths globally. Although the overwhelming majority of cases of Covid-19 are mild and there isn’t evidence that it’s widespread in the U.S., health officials worldwide have emphasized the need to contain the new disease early on.
As some observers have already pointed out, Americans’ habit of avoiding medical care for fear of what it might cost could undermine efforts to track and contain the coronavirus.
Cuomo’s insurance mandate will likely help alleviate concerns about cost and increase demand for testing, but New Yorkers should be aware that not all plans have to follow the directive. For instance, self-insured plans administered by large employers are subject to federal, rather than state law. It’s possible that these plans may opt to make testing free anyway, but members should check their coverage before getting tested.
The governor’s announcement did not mention testing for the uninsured, but if patients are seeking to get tested without insurance they should ask about potential costs and eligibility for financial assistance.
As Gothamist has reported in its series on health costs, #PriceCheckNYC, patients often don’t know what they will pay for a medical procedure until they see the bill—and getting tested for novel coronavirus is no exception. There have already been multiple reports of people getting hit with unexpectedly high medical bills after getting tested in the U.S.
One man resorted to GoFundMe to deal with the medical bills he received after being quarantined with his daughter in a children’s hospital in San Diego (the pair was ultimately released after testing negative for the disease). Because they were returning from Wuhan, China, where the COVID-19 outbreak originated, and had a relative who was infected, the quarantine was government-mandated. So the man was surprised to find $3,918 in charges when he got home.
After being contacted by the Times, a spokesperson for the children’s hospital said some of the charges were billed in error, adding, “We are working with government agencies regarding billing for these cases.” The ambulance company responsible for the bulk of the charges said only that they would look into the case.
Another man went to Jackson Memorial Hospital in Miami to be sure he didn’t have the disease when he felt under the weather after returning from a work trip to China. He ultimately tested positive for the flu, not COVID-19, but he still got billed $1,400 after insurance.
As of Monday, two patients have tested positive for novel coronavirus in New York. One is a 39-year-old Manhattanite who has been able to self-quarantine in her apartment. The other is a Westchester resident in his 50s who works in Manhattan, and has an underlying respiratory illness.
It’s possible that as additional cases are uncovered in New York, some patients may need to be treated in medical facilities. But DFS is directing insurers to make technology such as video chats available to patients for medical advice and treatment instead of in-person visits whenever possible.
DFS has also directed health plans to keep members up-to-date on their benefits related to novel coronavirus, noting that if an immunization becomes available for the disease, they will have to cover that, too.
Most recommendations from local health officials center around prevention—measures such as washing your hands frequently, sneezing into your sleeve instead of your hands, staying home if you’re sick, and getting vaccinated for the flu, which has similar symptoms to novel coronavirus.
Symptoms of COVID-19 include fever, cough and shortness of breath. According to the state, the criteria for getting tested include having traveled to countries that have been affected by COVID-19 such as China, Iran, Italy or South Korea, being in contact with someone who has, or being hospitalized with respiratory symptoms with no other explanation. The state says to call ahead to your health care provider before showing up.
If you do need to get tested and want to make sure it will be free, check with your health insurer. If you have employer-sponsored insurance from a large company, your plan might be self-insured and not subject to state law. The same goes for plans that are not based in New York state.
If you get a bill after getting tested or treated for novel coronavirus, you should try to contest it because you may be able to get your balance cleared. Keep in mind that you are still protected by the state’s surprise billing law. If you go to the hospital and get a bill from a doctor who’s out of network for your plan, your insurer is likely responsible for handling it.
Have you gotten tested for novel coronavirus or tried to get tested? Tell us about it at [email protected]. If you do get tested or treated and get billed, please consider submitting those and other medical bills to our interactive, searchable cost database below. You can find all of our #PriceCheckNYC coverage at gothamist.com/healthcosts.
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Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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