Untangling COVID-19 testing: What you need to know

May 19, 2020
By Regence

The topic of COVID-19 testing has entered nearly every news outlet and channel recently. Testing for COVID-19 antibodies has been particularly fraught with confusion.

Here’s what you need to know about COVID-19 testing:

COVID-19 diagnostic test (commonly known as antigen testing)

What it does: The diagnostic test can show if you currently have an active or recent infection of the COVID-19 virus.

When to get it: Your health care provider may order an antigen test to see if you have an active infection.

Test reliability: Antigen tests have 95% reliability rates for a positive test. However, negative tests may have an error rate of up to 30%.

Will your insurance pay for it: Regence will pay for a COVID-19 antigen test if ordered by a doctor and will pay for the associated office visit—both with no out-of-pocket costs for our fully-insured members and members of most self-funded plans.

COVID-19 antibody test

What it does: The antibody test (sometimes called serology test) detects antibodies in your bloodstream. When accurate, it can detect if you’ve had a coronavirus infection in the past, but not necessarily the SARS CoV2 virus, which causes COVID-19.

What it does not do: We do not know if having positive coronavirus antibodies results in immunity from getting COVID-19 again. And, the current accuracy or value of antibody tests is variable and can result in a very high number of false positives when the prevalence of disease is low (<5%) in the population. 

When to get it: There is no current clinical recommendation for antibody testing for individuals. However, your doctor may order an antibody test before a medical procedure or a hospitalization. As more research becomes available, clearer indications should be available on who should or should not be tested.

Test reliability: The current accuracy of the tests is not high enough to confirm a previous COVID-19 infection in all people, as noted by the U.S. Food & Drug Administration (FDA), American Medical Association, World Health Organization and other medical experts. We are advocating for the FDA to provide more rigorous guidelines for antibody tests because reliable testing may be an important component of reopening our communities.

Will your insurance pay for it: Regence will cover one antibody test per plan year, per member at no cost to fully-insured and self-insured members, including those with Health Savings Accounts (HSAs), if it is ordered by the member’s provider as part of appropriate medical care. Tests must be performed at a CLIA-certified lab or the test manufacturer must have FDA-Emergency Use Authorization. Additional antibody testing may be covered if the test is medically justified and all other criteria are met. As with other tests for employment, such as drug tests, antibody tests for employment purposes are not covered by insurance. Public health surveillance testing is not covered under the medical plan.

Finally, unfortunately this public health crisis has also attracted its share of bad actors selling 21st century snake oil. Read our earlier blog post on protecting yourself against COVID-19 scams.