COVID-19 Archive
Fair Testing Practices & Other Resources
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How Cost Variability in COVID-19 Testing Affects Your Health Plan
Since Advantage Health Plans Trust and The Kempton Company don’t profit from health plan savings, every dollar saved is a dollar made available to everyone in your plan who may need it. Being cost-conscious is vital to the success of your plan.
Included below is important information about the cost of COVID-19 testing and resources to help you make a valuable choice. Our goal is to bring transparency and awareness to COVID-19 cost variability. While COVID-19 testing is covered by your plan with no cost-sharing, it is still important to keep cost in mind when choosing a testing site, because medical providers are free to choose what they charge for testing, and the cost for COVID-19 testing varies significantly between medical providers.
Find a COVID-19 Testing Provider
We have created color-coded lists by state that includes every provider who has filed a claim for COVID-19 testing with any of our health plans. Green indicates a provider has fair pricing, yellow is average pricing, and red is high pricing.
Click the PDFs below to view providers and pricing.
What is a Fair Price for COVID-19 Testing?
Testing pricing in Oklahoma, Texas and surrounding states varies from a fair price of $65 to more than $800!
Remember, these prices do NOT include other associated costs.
Ask About Cost
While finding an appointment and getting your test results timely are important, make sure to ask the provider how much they charge for testing AND other associated charges.
How Much Does It Cost?
A Kaiser Family Foundation analysis found the cost of a single COVID-19 test can range from $20 to $850. Currently, the Medicare reimbursement rate for a COVID-19 test is $51 to $100, based on the type of test.
It is important to note that the testing costs do NOT include any associated charges, such as office visits, specimen collection, etc. In the case of an emergency room (ER) visit, the charges for the ER physician or ER department can be thousands of dollars.
Location is Important
Many medical providers and facilities provide COVID-19 testing, but choosing the appropriate location for your situation is important. Independent laboratory providers such as Diagnostic Laboratory of Oklahoma (DLO), Quest Diagnostics and Clinical Pathology Laboratories (CPL) generally provide the lowest cost and most convenient testing options. Emergency rooms and hospitals charge the highest amount for testing. ERs are for treating true emergency and life-threatening situations that require immediate medical attention.
It is important to use an ER ONLY if you are experiencing a true medical emergency.
Helpful Resources
A list of helpful resources to assist and guide you.
At-Home Testing
Under President Biden’s action plan, over the counter, at-home COVID-19 tests are required to be covered by health plans.
Many Pharmacy Benefit Managers (PBMs) are setting up direct pay options so that members may obtain their COVID-19 at-home tests directly from the pharmacy at no cost. To find out whether your PBM has this functionality, or what the process is for reimbursement, please call us.
Contact Us
The Kempton Company is here to help with all of your Advantage Health Plans Trust needs. Don’t hesitate to reach out!