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Why COVID-19 rapid results cost up to $300 amid omicron surge

People have to pay hundreds of dollars upfront although state and federal rules require COVID tests to be free or covered by health insurance.

CALIFORNIA, USA — This story was originally published by CalMatters.

When Rebecca Santucci of Lakewood learned that her sister, Stacy, may have been exposed to COVID-19, she set out to look for a rapid test. She needed to know quickly whether their 88-year-old father was at risk.

Pharmacies had been wiped out of home test kits, and testing clinics were booked solid for at least two weeks. On Amazon, she found a set of two at-home tests for $38, but they wouldn’t arrive until next month. And anything that required waiting hours in line wouldn’t work for her sister, who has Down syndrome and anxiety.

Eventually, she found a slot for a rapid antigen test at a private drive-thru clinic on the city of Lakewood’s website. But it was five days after Stacy learned of her potential exposure. 

The price tag for the test: $129.

“We ended up paying the money but it killed me to do it,” Rebecca said. Stacy tested negative, so at least they finally got some peace of mind. 

With the explosion of the highly transmissible omicron variant, more Californians find themselves seeking tests wherever they can find them. State and local testing sites offer free COVID-19 tests but they are swamped, forcing people to seek private pop-up clinics. 

Quick results often come with hefty upfront costs: Some clinics charge nearly $300 for a rapid PCR test. 

Although state and federal regulations require COVID tests to be free or covered by health insurance, people often have to pay upfront, and the amount is unaffordable for many Californians. 

Those who can’t afford to pay will often have to wait hours in line at local and state free testing sites, and then sometimes wait days for the lab results.

“There is a requirement that testing be free, but there is no requirement of how fast those test results need to be returned,” said Shira Shafir, a UCLA professor of epidemiology. “With this omicron surge, some people are again waiting four to five days for those lab results and at that point those results are essentially useless.” 

Adding to the demand for quick results is that certain places demand proof of testing within a time frame of 24 to 72 hours. People need them to visit nursing and senior homes, return to daycare programs or board flights to Hawaii or overseas.

Pop-up sites at California’s international airports charge upfront. At San Francisco International Airport, a rapid test is $275. At Los Angeles International Airport, a rapid PCR test with results in one hour costs $199. According to one LAX provider, Clarity Mobile Venture, debit or credit card payments are required, although a receipt is provided for insurance reimbursement. At San Diego International Airport, the cost is $135 to $165, and at Long Beach Airport, a test with 1.5-hour results costs $250.

At the Lakewood clinic where Santucci went, costs range from $129 for a rapid antigen test with one-hour results to $299 for a PCR test with two-hour results. The clinic also advertises a free standard PCR test with results in two or more days.

“With rapid tests, what people may be paying for is the guarantee of quick results,” said Shafir. “The test site is not always pitching it that way.”

PCR and antigen tests are both used to diagnose COVID-19; antigen tests can yield faster results but PCR tests are more sensitive to detecting the virus so they are considered more accurate. 

Health experts say getting results quickly is vital to protecting people and avoiding long quarantines, but rapid tests have long been in short supply.

Save your receipts 

Californians have an array of places where they can be tested: a hodgepodge of pharmacies, community clinics, government mass-testing sites and private pop-up sites. Many of these are free, but they are booked for weeks. Some pop-up testing sites charge upfront, creating confusion as to why, since testing is supposed to be free.

At most pharmacies and doctor offices, providers do not charge people directly. Instead, they collect insurance information so they can be paid. But some private testing clinics charge individuals, who are then responsible for seeking reimbursement from an insurer. Claims can be filed online or sent to the insurer by mail.

But it’s not always a guarantee that they’ll get their money back.

Stacy Santucci is covered by Medicare, which covers people with disabilities. Rebecca said she did not receive a receipt after her sister’s test, but she had an email confirmation from the testing provider, Covid Clinic. When Rebecca called her sister’s Medicare plan, she was advised to print the email and send it in by snail mail, but there was no assurance she’d be reimbursed because the printed email might not suffice. 

Today, as COVID-19 case rates in California have jumped to their highest levels yet — more than six times the peak of the delta variant wave — updated workplace rules are kicking in to better help protect workers vaccinated against COVID-19.

The revised rules come from the California Division of Safety and Health — also known as Cal/OSHA — which regulates health and safety in California workplaces. 

Changes include:

Testing: If there’s an outbreak at work, employers need to make FDA-approved COVID tests available to exposed employees at no cost, during paid time — and now that also goes for vaccinated, asymptomatic workers who were exposed. 

Tests can no longer be self-administered and self-read. In other words, workers can’t take a test at home by themselves. Tests that are processed by a lab, or observed by a medical professional during a telehealth appointment, or administered and observed by medical professionals or an employer are still okay. 

Who gets sent home after exposure: Previously, if a fully vaccinated person had close contact with a COVID-positive person, but didn’t develop symptoms, they didn’t need to be sent home from work. Now, vaccinated asymptomatic people need to be sent home from work unless they wear a mask and maintain 6 feet of distance from others for two weeks. 

Updating what counts as a mask: If workers choose to wear a fabric mask, rather than a surgical or medical one, the new rules clarify that it needs to be sufficiently thick and tightly woven to not let light pass through it when held up to a light source. 

The rules also require employers to ensure workers wear masks as required by California’s public health department. On Dec. 15, a new statewide mask mandate that includes workplaces went into effect, and it’s slated to remain in place until Feb. 15. Workers need to wear masks indoors, but if a worker is alone in a room with a closed door, or if the workplace is a single person operation, masks aren’t needed

If someone gets exposed to COVID at work, state law requires that employers send them home and maintain their usual pay until they meet the return to work criteria set forth by the workplace rules. 

However, employers aren’t currently required to offer additional sick leave for COVID as a general policy. A state law requiring employers with 25 or more workers to offer up to 80 hours of supplemental paid leave for COVID expired in September leaving workers legally entitled to just three days of sick leave annually. 

Federal guidelines recommend that anyone who tests positive for the virus quarantine for five days. 

Some legislators are pushing to bring back supplemental COVID sick leave in 2022, and the governor said working on sick leave was a “top priority” for him when he rolled out his budget proposal in early January. 

Business pushes back on California COVID rules

Business and industry advocates protested the new rules at a public meeting in mid-December. Melissa Patack, vice president of state government affairs for the Motion Picture Association, said the new rules requiring asymptomatic, vaccinated workers who were exposed to maintain 6 feet of distance would be challenging for her industry. 

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