Paying for Covid tests gets complicated; sites close down

Filed Under: Costs, Patients, Providers

covid swab illustration

Paying for Covid tests has gotten a lot more complicated. The tests are no longer routinely covered by insurance or by federal money for many people, in a change from previous practices. Also, a number of testing places have closed, making it harder to get tested.

This didn’t happen overnight. The federal government reduced coverage for testing  for uninsured people as a result of the deadlock over passing legislation for additional money in late March. Some insured people are also finding that their tests are no longer covered under certain circumstances.

We have been hearing at our vaccine and testing van in Queens that some people who need a test result that’s not from the ubiquitous in-home tests are being required to pay — which is why our free van is so popular.

Couple that with a rise of — and sporadic mini-shortages of — in-home testing kits, and you have another example of public health gone wrong in the middle of a pandemic. Less testing, and less publicly reported testing, means we don’t actually know how widespread the pandemic is — we are left with measuring by hospitalizations and deaths, which can actually minimize the public sense of risk, which then contributes to less masking, less vaccination and wider spread.

The Walgreen’s scene, by a pharmacy technician

A pharmacy technician from Walgreen’s posted this on Reddit recently.

“Hi! Pharmacy technician here 🙂

“Covid testing funding is no more, so without insurance PCR and rapid (NAAT) tests are both $129.

“Walgreens around the country is having issues billing the medical side of insurance because like most things they make us do, they didn’t make sure it worked before springing it on us.

“If you’re symptomatic or have been in close contact with someone with covid, your insurance might reimburse you. But it’s not a guarantee. If you need one for travel, you’ll have to pay out of pocket.

“Had a few people upset today (reasonably so) because they either had to pay or not get the test. So here’s an informative post. Ask any questions you might have and I will try to answer them”

Neighborhood info

In my neighborhood in southern Westchester County, in New York, the local Facebook groups were sharing information.

While many places are no longer requiring that you display proof of vaccination or a negative test, two individuals — one going to camp, one starting a new job — were required to deliver negative PCR results, their parents said.

“Not free but I used value drug Bronxville a few days ago. Super easy. Booked online.”

“Cvs or Walgreens. Online appt, drive through test. Free”

“CVS by stop and shop was free for me a few weeks ago”

“We have had good luck with CVS. Usually within 24 hours. Test in the morning and you should have it by the end of the next day.”

“Rite aid Bronxville but $200. Less than hour”

At-home tests — in and out of shortages

Part of our VEPE grant includes at-home tests to distribute to the community in Queens Village. While we have fairly consistently been able to get in-home tests to distribute, we have noticed lately that there have been some shortages in supply.

We’ve been following this from the on-the-ground vantage point of our New York Health + Hospitals mobile van parked twice a week outside Ss. Joachim and Anne Catholic Church, opposite Wayanda Park, in Queens Village, an undervaccinated neighborhood on the easternmost edge of New York City, bordering on Long Island.

Our van  is primarily designed to make vaccines more accessible as part of a grant to expand vaccine uptake in undervaccinated neighborhoods. The grant is part of the Vaccine Equity Partner Engagement program, with The Fund for Public Health in NYC and the NYC Department of Health and Mental Hygiene, funded by Centers for Disease Control money. Our three media organizations partnering in the grant are ClearHealthCosts, Epicenter-NYC and TBN24.

I have seen in-home tests pop up at unexpected places — not just my library, but also the public swimming pool near my house, where there were 3 free tests on a table at around 5:30 p.m. one day, and none the next day.

From our experience at the van, in April and May, people wanted fewer tests and more masks. Now it’s back to wanting tests — just at the point when they’re not always available in volume.

For our Queens Village van, we are allowed to order 800 tests a week. Some weeks we give them all away — some weeks we don’t get any at all.

A muddy picture of the pandemic

The murky scene in testing has resulted in a situation where the shape and trajectory of the pandemic are something of a mystery, The New York Times reported July 5 in a story headlined “Reduced virus data reporting and testing in the U.S. are blurring the real-time look at the pandemic.”

“The vast majority of the positive results from popular home test kits are not included in official data, and not everyone who gets infected knows or gets tested,” The Times wrote. “Many Americans appear to be moving even further away from focusing on daily case counting —- which, to be sure, have always been an undercount of total infections —- as a measure of the nation’s pandemic health. But other Americans with risk factors have said that they feel ignored and abandoned as their governments and neighbors have sought a return to normal.

“And some scientists estimate that the current wave of cases is the second largest of the pandemic.”

Reporting on the cutoff of funds, NPR wrote: “Gregg Gonsalves, an epidemiologist at Yale University who studies public responses to infectious disease, notes that the federal government’s messaging about how the pandemic is easing may be in part to blame for the impasse.

“‘I don’t understand how they can’t see the cognitive dissonance of the downplaying of the pandemic and then the need to get more money from Congress,’ he says. ‘Either it’s a crisis and you need more money, or it’s not a crisis and you don’t need more money.'”

New York City closing sites

The number of test locales in New York has shrunk dramatically, according to Betsy Ladyzhets in Gothamist.

“A Gothamist analysis of municipal data found that the number of NYC Health + Hospitals testing sites were cut in half citywide from mid-February to mid-April — from 270 sites to 144 locations — leading to fewer hours of testing availability,” Ladyzhets wrote. “This shrunken landscape includes both brick-and-mortar clinics as well as mobile testing vans.

“Practically speaking, these trends meant that New Yorkers had 15% fewer hours to get a free PCR test — given more than 10,000 hours were available the week of February 14th, when the omicron surge was waning, versus 8,500 hours the week of April 18th. By this part of the spring, the coronavirus was rebounding again, driven by newer versions of the omicron variant.”