If you have COVID-19 symptoms, you'll need to talk to your doctor and possibly get tested. But how does it work? Where can you be tested? And, is it covered (or not covered) by your health insurance?
There is no shortage of information available about COVID-19 testing. But there is one, basic thing to understand about how testing is covered by your Wellmark health insurance: As long as a COVID-19 test is ordered by a physician, Wellmark Blue Cross and Blue Shield covers COVID-19 tests and related services to diagnose or detect the virus.*
Where to get a test, and how it’s covered
Generally, there are three ways to get tested for COVID-19:
Throughout the U.S., COVID-19 tests are available at no cost at health centers, select pharmacies and other established locations. The Families First Coronavirus Response Act External Site ensures testing is free to anyone in the U.S., including the uninsured. The Act remains in place as long as the country is in a public health emergency, as declared by the federal government. To find a COVID-19 testing location near you, visit The U.S. Department of Health and Human Services External Site. Each testing site can help you determine whether or not you should get a COVID-19 test, along with specific instructions on how to get tested.
Iowa’s program, called Test Iowa External Site, has drive-up locations throughout the state. It includes an online assessment that was developed in coordination with the Iowa Department of Public Health. South Dakota has a similar public testing program External Site through the South Dakota Department of Public Health. These programs do not submit health insurance claims and are free of charge.
Health care provider testing
Hospitals, clinics, urgent care centers and other health care providers all have their own processes in place for COVID-19 testing. If you are experiencing a fever or acute respiratory symptoms (cough or shortness of breath), or have been in close contact with someone who has tested positive for COVID-19, call a health care provider before going to a doctor's office, clinic, urgent care or emergency department. During that call, your provider will assess your symptoms and direct you to the appropriate care.
Providers may have different procedures for handling COVID-19, so be sure to do some research online Opens New Window or call your doctor before going to your appointment. Also, check if your provider has a virtual visit option so you can see the doctor without leaving home. If you're a Wellmark Blue Cross and Blue Shield member, be sure to check your benefits in myWellmark® Secure to see if you have coverage for virtual visits.
If you have a COVID-19 test through your doctor or hospital, present your Wellmark ID card. The COVID-19 test will be processed through your insurance and covered in full.
“Many people are required to have a COVID-19 test before receiving a medical procedure or screening, such as a colonoscopy,” says Mike Fay, vice president of health networks and innovation at Wellmark Blue Cross and Blue Shield. “In this case, follow instructions provided by your health care provider. The testing will be billed to and paid for by your health insurance.”
You may need to get the results of a COVID-19 test quickly, for example, if your employer requires a negative test in order for you to go back to work, before flying, or if you are traveling to a location that requires proof of a negative test. In this case, you may not have coronavirus symptoms, or you may be unable to schedule your test through a community testing site or through your doctor. By searching online, you will likely find a number of independent vendors that are conducting tests.
“These companies are filling a need for people seeking quick results. And they are an option if you need a test but don't meet the criteria to receive a test through your health care provider or community-based testing site,” says Fay. “Often, you can have results in a matter of hours.” According to Fay, while some of these companies can provide reliable test results, you should be careful. For example, beware of any product that claims to treat a wide range of diseases, claims to have a 'secret' ingredient, or promises a quick fix. If it seems too good to be true, it probably is.
Before going ahead with it, do your homework to be sure you know what you’re getting into. “Ask yourself, ‘Why do I need a test and what am I going to do with the results?’” says Fay. “It may be worth it if you are seeking peace of mind, and you're willing to pay for the cost out of your own pocket."
COVID-19 tests administered by independent vendors generally aren’t covered by health insurance. “Insurance covers tests that are approved by the Food and Drug Administration (FDA) and ordered by a heath care provider” says Fay. “There are fraudulent tests and treatments External Site out there. Be sure to do your homework first,” he warns.
If your employer is requiring diagnostic tests for COVID-19 — even when not ordered or administered by a physician — before you return to work, the test may not be covered by your Wellmark plan. In this case, your employer may be responsible for the full cost of the test. Before getting a test, check with your human resources department to verify coverage.
What is a COVID-19 test like?
Nasal swabs External Site and home test kits External Site are all more widely available External Site now, and new, faster testing methods may be on the way External Site. But for now, a test that detects COVID-19 is a direct, viral test that takes samples from the inside of your nose and/or throat to see if you are currently infected. Timing is key with the test and it can produce inaccurate results if you get tested at the wrong time.
It’s important to remember that no test for COVID-19 is 100 percent accurate, so you should follow prevention guidelines from the CDC External Site if you test positive, if you test negative, or if you haven’t taken a test at all.
For more information about COVID-19 testing, plus other benefit information related to COVID-19, visit Wellmark.com/Coronavirus Opens New Window. You can also check out our coronavirus tag here on Blue.
*Some self-funded employer plans may differ in coverage. If your employer has a self-funded plan, please refer to your benefit documents/resources or log in to myWellmark Secure if you have questions related to COVID-19 testing.