Untangling COVID-19 testing: What you need to know

August 03, 2020
Coronavirus
By Regence

***Updated Aug. 3, 2020***

The topic of COVID-19 testing is all over the news lately. It's easy to get confused.

Here’s what you need to know about COVID-19 testing, what kinds of tests are available and what's covered by insurance. Visit Regence's COVID-19 page for additional information. 

Antigen or molecular diagnostic test

What it does: The antigen or molecular diagnostic test can show if you currently have an active or recent infection of COVID-19, which is caused by the SARS CoV2 virus.

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

Test reliability: Many antigen and molecular diagnostic tests have 95% reliability rates for a positive test. However, negative tests may have an error rate of up to 30%. Visit the U.S. Food & Drug Administration (FDA) website for the most up-to-date information about COVID-19 testing.

What insurance covers: Regence will pay for a COVID-19 antigen or molecular diagnostic 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. Tests must be performed by a CLIA-certified lab or the test manufacturer must have FDA Emergency Use Authorization. 
 

COVID-19 antibody (also known as serology) test

What it does: The antibody 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: The antibody test does not tell you if you have an active COVID-19 infection, and, if positive, it does not tell you if you are immune from a future COVID-19 infection. We do not yet know if the presence of antibodies protects you against future infection.

When to get it: There is no current clinical recommendation for antibody testing. However, your doctor may order an antibody test associated with 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 antibody tests is improving, although, there remains no evidence of immunity to future COVID-19 infection. Visit the FDA website for the most up-to-date accuracy information on antibody testing.

What insurance covers: Regence will cover antibody tests 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. 
 

COVID-19 diagnostic and antibody tests

What insurance does not coverAs with other tests for employment, such as drug tests, antigen, molecular or antibody testing for the purposes of employment, surveillance, tracing, tracking or extracurricular activities, such as travel, school, sports or summer camps, is not covered by insurance.

Of note: requiring testing for COVID-19 antibodies before allowing employees to re-enter the workplace is not allowed under the Americans with Disabilities Act (ADA). Learn more about the EEOC’s guidance on COVID-19 here.

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