Expand AllClick here for a more accessible versionCommon Questions
Get the answers to frequently asked testing coverage questions below.
There are a variety of free and/or low-cost health care resources available to people who are uninsured, underinsured, or economically disadvantaged. The federal and non-profit organizations listed below may provide or help cover a range of medical, dental, pharmacy, vision and/or behavioral health services.
Free Clinic Association of Pennsylvania
Free & Charitable Clinics are safety-net health care organizations that utilize a volunteer/staff model to provide a range of health services. Visit Free Clinic Association of Pennsylvania to find free or charitable health clinics in your area.
Federally Qualified Health Centers
Federally Qualified Health Centers are in most cities and many rural areas. These health centers provide comprehensive primary and preventive care for all ages, regardless of your ability to pay or health insurance status. Many health centers have COVID-19 tests available. Fees for services are on a sliding scale based on your income. Find a Federally Qualified Health Center in Pennsylvania near you.
CARES Act
If you are uninsured, the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security (CARES) Act may provide reimbursement to health care providers and facilities for your COVID-19 testing and treatment.
Whether you are experiencing symptoms or not, now is a good time to see if you are eligible for enrollment in health care coverage.
Some health programs, like Medical Assistance and CHIP, will enroll you at any time throughout the year. Some health insurance coverage, like the Marketplace, may only be available if there is a special enrollment period or during the annual open enrollment period. You may qualify for a special enrollment period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.
The Pennsylvania Association of Community Health Centers (PACHC) offers free, personal, no pressure, no obligation, non-biased enrollment assistance. PACHC and its network of Community Health Centers are available to assist you in navigating and enrolling in the Health Insurance Marketplace, Medical Assistance, Medicare and CHIP. Certified Exchange Assisters are available throughout Pennsylvania to help you enroll in these programs.
Here is a list of exchange assisters in your area. You may also search by using the find a health center page. If you have additional questions or need further assistance, please contact the PACHC's Navigator Hub at 1-866-944-CARE (2273).
You may also use COMPASS to sign up for Medical Assistance. COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs like Medicaid and CHIP. Visit COMPASS at www.compass.state.pa.us.
If you would prefer to research signing up for a Marketplace plan without assistance, you may visit pennie.com.
If you are uninsured, the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security (CARES) Act may provide reimbursement to health care providers and facilities for your COVID-19 testing and treatment.
If you have an excepted benefit policy, short-term, limited duration health insurance coverage, or a health care sharing ministry plan, you are considered "uninsured," and the Families First Coronavirus Response Act may provide options to cover your COVID-19 testing.
However, if you believe your insurance company should be covering COVID-19 testing or treatment but is not, you need to determine what kind of health care coverage you have and contact the appropriate agency.
If you have individual, small group employer, or large group employer coverage:
The Pennsylvania Insurance Department
Web: www.insurance.pa.gov
Phone: 1-877-881-6388 or 717-783-3898
If you have employer self-funded coverage
The United States Department of Labor
Web: https://www.dol.gov/agencies/ebsa
Phone: 1-866-275-7922
Does your employer self-fund the health care coverage it provides?
Sometimes employers purchase coverage from a health insurance company for a set premium and the health insurance company pays all of the claims for health care services. This is called being fully insured. However, in many other cases, your employer will pay claims for health care services themselves and use a third party, like a health insurance company, to administer their health care coverage. This is referred to as being self-funded (or self-insured). If you are not sure if your employer self-funds or is fully insured, contact your human resources department, benefits manager, or the person in management that handles health care coverage and they can tell you.
If you have Medicare coverage:
Medicare
Web: www.medicare.gov
Phone: 1-800-MEDICARE
If you have Pennsylvania Medical Assistance (Medicaid):
The Pennsylvania Department of Human Services
Web: http://www.healthchoices.pa.gov
Phone: 1-866-550-4355
If you have Children's Health Insurance Program (CHIP) coverage:
Pennsylvania's Children's Health Insurance Program
Web: www.chipcoverspakids.com
Phone: 1-800-986-KIDS (5437)
The new Public Charge Rule is a federal rule that came into effect on February 24, 2020. A "public charge" is someone who needs to rely on public assistance; the rule was established to ensure that individuals can sustain themselves and not burden society. (There are lawsuits going on about this rule; please check with your legal services provider if you have any questions.) If an individual wants to immigrate to the United States or adjust their lawful permanent residence (obtain a Green Card), the person must demonstrate that they will not be a public charge. Under the new public charge rule, the federal government looks at certain benefits to decide if someone is a public charge, such as needing Medicaid (but not emergency services, children under 21 years, pregnant women and new mothers), Supplemental Nutrition Assistance Program (SNAP, EBT, Food Stamps), Federal Public Housing and Section 8 assistance, and cash assistance programs (like SSI, TANF, General Assistance). Please check with your legal services provider if you have any questions. You can also learn more at uscis.gov.
Can I get tested for COVID-19 despite the Public Charge Rule?
Yes, the U.S. Citizenship and Immigration Services encourages all those, including undocumented individuals, with symptoms that resemble COVID-19 (fever, cough, shortness of breath) to seek necessary medical treatment and preventive services. Immigration officials have stated that testing, treatment, and preventive care related to COVID-19 will not negatively affect an individual's public charge analysis. To learn more, visit uscis.gov.
Use this guide from the National Immigration Law Center to learn more about the rights of health care providers and their patients.
The Pennsylvania Department of Health encourages each facility's staff to consult with their employer to determine how the test should be paid and whether there are any particular testing arrangements in place for that facility's staff.
If there are staff without medical insurance, is there any payment mechanism for the test?
The Health Resources and Services Administration (HRSA) will cover the cost for testing for uninsured generally at Medicare rates. Information is available at https://www.hrsa.gov/coviduninsuredclaim/frequently-asked-questions.
A health care provider is an "attending healthcare provider" if they are licensed or otherwise authorized under applicable law, acting within the scope of the provider's license or authorization, and responsible for providing care to the patient. An attending healthcare provider does not have to be directly responsible for providing care to a patient to be considered an attending provider but must be a provider who makes an individualized clinical assessment to determine whether the test is medically appropriate. Your primary care physician, a provider (i.e. a nurse, physician's assistant, doctor) at a drive through testing site, or a pharmacist are examples of people who may be considered an attending provider if they make an individualized clinical assessment that the test is medically appropriate for you.