WASHINGTON — When the COVID-19 public health emergency ends in the United States next month, you’ll still have access to a slew of tests, but with one big difference: who pays for them.
For the first time, you may have to pay some or all of the costs, depending on insurance coverage and whether the tests are done at home or in a doctor’s office.
But there’s still time to get free tests before the May 11 change, and there might still be free tests available afterwards. Some state and local governments may continue to distribute free home tests at clinics, libraries and community centers. And the federal government, for now, is still sending free tests through the U.S. Postal Service to households that haven’t already received two mailings.
And don’t overlook those old tests you haven’t used. The expiration date on the packaging may have been extended. The Food and Drug Administration website provides a list to check and see which tests are still good.
Here’s a look at what the end of the government’s emergency declaration on May 11 means for testing:
The biggest changes will be to over-the-counter testing, which now accounts for the vast majority of testing in the United States.
Since early 2021, the federal government has required all private insurers to cover up to eight COVID-19 tests per month. This requirement will soon disappear. Coverage is also set to expire for tens of millions of seniors under the federal government’s Medicare program, though some members of Congress are pushing to expand the benefit.
Learn more: Stock up on free COVID-19 home tests while you can
Although some private insurers may continue to cover all or part of home testing, there will no longer be a national rule. A two-pack of tests usually costs between $20 and $24.
“What we will see is a hodgepodge of approaches from different insurance companies, which will make it difficult for individuals to know what they are going to pay,” said Christina Silcox, of the Duke Margolis Center for Health Policy, which recently published a report on the outlook for testing.
An exception will be for people enrolled in the government’s Medicaid program for low-income individuals and families, who will continue to receive free tests until September 2024.
Americans can also expect to pay more for any COVID-19 test performed at a hospital, clinic or doctor’s office.
Insurers have been prohibited from charging copays or any other cost-sharing fees related to COVID-19 testing. This requirement also ends next month.
While insurers will still cover the costs of basic tests, some people may have to pay new fees for part of the price of the test or for the services of the healthcare professional performing it. Lab tests have typically hovered between $70 and $100, and some of that could be passed on to patients.
COVID-19 vaccines and medications will remain free because they are not paid for by insurance, but by the federal government. One concern is that the uncertainty surrounding the costs of testing could lead to processing delays. Current treatments for high-risk patients, such as Paxlovid, generally need to be taken within the first few days of symptoms to be effective.
If people are worried about testing costs, “they may wait a few days to see if things clear up and miss that five-day treatment window,” Silcox said.
The United States struggled to build test manufacturing capacity in the first two years of the pandemic, with demand waning after each surge. Experts fear the country could be caught off guard again after the federal government stopped buying tests in bulk.
It was only after the US government announced it would buy 1 billion tests that production leveled off, peaking at 900 million monthly tests in February 2022.
“These bulk purchases essentially secured the market for the test makers,” said Jennifer Kates, senior vice president of the nonprofit Kaiser Family Foundation.
In September, manufacturers were still producing more than 400 million tests per month, far exceeding US testing levels, according to Duke researchers.
Companies including Abbott Labs say they will be able to scale up test production as needed. But the company declined to discuss specific production targets or how they will be affected by the end of the health emergency.
Congress has been unwilling to buy more tests, and the Biden administration has not proposed new spending in its latest budget.
“That initial federal government guarantee that deals with volatility testing will no longer be there,” Kates said.
The hundreds of different COVID-19 tests authorized by the Food and Drug Administration over the past three years will remain available after May 11. This is because the FDA cleared these products under a separate emergency measure that is unaffected by the end of national reporting.
Still, FDA officials have encouraged test makers to seek full regulatory approval, which will keep their products on the market indefinitely. Last month, the FDA officially approved the first rapid COVID test.
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