Consumer Alert: Diagnostic COVID-19 Test Costs Covered by Insurance Plans
Michigan is working to ensure that anyone who needs a COVID-19 test can get one. Governor Gretchen Whitmer and the Michigan Department of Insurance and Financial Services (DIFS) are alerting Michiganders that diagnostic COVID-19 testing for those who meet testing criteria should be covered by most health insurance plans without any out-of-pocket cost. There are various ways that costs for the test may be covered, and resources are available to help answer questions.
As of March 2020, federal law requires most insurance plans to cover — at no out-of-pocket cost — diagnostic COVID-19 testing and related services provided by a health care provider. These plans include individual and group health insurance plans offered on and off the Health Insurance Marketplace, employer-based plans, non-federal governmental plans, and church plans. Related services that are covered at no cost include office visits (both in-person and telehealth), urgent care visits, and emergency department visits that are related to testing for COVID-19.
Consumers with health insurance seeking COVID-19 testing should contact their insurance company to find out what is covered if they plan to be tested at a site that requires payment up front or indicates they will be billed for the test. Some insurance companies may be required, for tax reasons, to reimburse consumers for out-of-pocket costs, rather than paying those costs directly to health care providers.
Insured consumers who pay up front or receive a bill for COVID-19 testing should contact their insurance company for assistance. Consumers who are unable to resolve the issue with their insurance company can contact DIFS for assistance Monday through Friday from 8 a.m. to 5 p.m. at 877-999-6442, or file a complaint at Michigan.gov/DIFScomplaints.
In accordance with federal law, consumers with Medicaid or Medicare may also receive a no-cost COVID-19 test and related services provided by a health care provider. Medicare beneficiaries who believe they have been charged inappropriately may contact 800-MEDICARE (1-800-633-4227); Medicaid beneficiaries should contact 800-642-3195.
To find a testing site, visit Michigan.gov/coronavirustest or call 888-535-6136.