Your health plan covers COVID-19 testing in full*, including antibody testing, if:
- You show possible symptoms or have had known close contact with someone else who has tested positive for COVID-19 AND
- It is ordered by your doctor and deemed medically appropriate
Please Note: COVID-19 testing for those who do not have symptoms, but who are required to have testing by their employer, school or a government or public health agency, is not covered.
Free COVID-19 testing is available at any of the 700+ testing sites throughout New York state operated by the New York State Department of Health (NYSDOH). Anyone can get tested and you do not need to show symptoms of COVID-19, although appointments may be required. To find a NYSDOH testing site, please call the health department’s 24-hour hotline at 1-888-364-3065 or refer to the New York Department of Health website.
*For self-insured group plan members, please consult with your employer’s human resources or health benefits representative for COVID-19 testing-related benefits.
What are the different COVID-19 tests?
What are the standards that apply to these tests for them to be considered for coverage?
If my employer or school requires me to have a COVID-19 test, will my insurance cover the cost?
No. Testing that is ordered or performed solely for purposes of pandemic control or re-opening the economy, and not based on a determination by an attending provider that the test is medically appropriate for the diagnosis and treatment of an individual is not covered under the member’s health benefit. This includes tests performed on someone with no symptoms to assess health status as required by parties such as a government/public health agency, employer, school, or camp.
Please note that free COVID-19 testing is available at locations across the state operated by the New York State Department of Health. Individuals do not need to be symptomatic or essential workers to obtain a test from these state sites. For more information, call the health department’s 24-hour hotline at 1-888-364-3065.
I am curious about my own immunity to COVID-19. If I ask my doctor to order the antibody test for me, will it be covered by my health insurance [health benefits plan]?
If I order a home testing kit on my own, will you reimburse me for that?
Can I get my test done at my local pharmacy and have my insurance pay for it?
If I go to an urgent care center, can I get my test done there and have it covered?
Do these rules apply to members of Medicaid managed care or Child Health Plus?
Do these rules apply to members of Medicare Advantage plans?
- Do not go directly to any doctor’s office, emergency room or urgent care center – Call your primary care doctor first
- Practice social distancing
- A telehealth visit using your smartphone, tablet, or computer is also an option for initial screenings. Note: Due to high call volumes, wait times may be longer than usual.
- Go to your health care provider’s website to set up a telehealth visit
- Or you can set up a telehealth visit at ExcellusBCBS.com
- You can contact your local county health department for testing options if you don’t have a primary care doctor.
Given that the COVID-19 situation is rapidly evolving, the best resources for up-to-date health information are:
Remember
Follow the 3 W's
You may think you know how to wear a mask, but these quick tips will help you know you're fully protecting yourself.
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