By now you have probably taken a COVID test or two. How much did you end up paying for it? By federal law, COVID tests are free regardless of having insurance. Yet many people end up with bills for hundreds even thousands of dollars for a simple test. KPRC 2 Investigates team getting answers and shows you how to find a free test when you need one.
Shocking COVID test bills
His bags were packed and Jorge Arguelles was ready to take off for a summer vacation with his daughters. But the day before departure, Jorge learned a coworker tested positive for COVID-19. He needed a test and quick.
Jorge drove to Memorial Village ER on Memorial drive near Dairy Ashford.
“Right away, someone came out wearing scrubs and they asked for my insurance,” said Jorge.
The routine nasal swab was done in the comfort of his car and he was on his way. Jorge said the entire visit was quick.
“Fifteen minutes, in and out, which I thought was very convenient,” said Jorge.
The quick testing may have been convenient but it turned out costly. When Jorge got his explanation of benefits from United Insurance, he saw Memorial Village ER filed two claims for that 15-minute visit.
Insurance company charges for COVID test
One charge from Memorial Village ER was $2,016 dollars for lab work. Another charge was for a physician fee of $1,736 for Dr. Amir Zegar. All total the bill ended up being $3,752-dollars for just one COVID test. Jorge could not believe his eyes when he opened up the bill.
“I was in shock at first. I never saw a doctor. I never even got out of my car, never opened my door,” said Jorge.
KPRC 2 Investigates stopped by Memorial Village ER to get an explanation of the charges.
Amy Davis: “So you guys billed someone $3,700 for a COVID test?”
Dr. Vivian Nriagu: “Thank you for coming to the emergency department. We appreciate your time here. But we’ve asked you to talk to Sherrie Peterson, okay,”
Amy: “But Sherrie doesn’t work here. You own the place.”
Dr. Nriagu: “Sherrie is actually our representative and we’ve asked you to call Sherrie.”
Sherrie, the company’s public relations representative, sent this statement:
“Memorial Village Emergency Room’s billing practices are in strict compliance with all state and federal laws.
The CARES Act requires health insurers to pay for the costs of COVID-19 tests. And invoice charges represent a starting point for negotiating fair reimbursement.”
“Those sound like a whole lot of words just to justify price gouging,” said Jamie Dudensing, Texas Association of Health Plans.
Why are some COVID tests so expensive?
Jamie Dudensing is the CEO of the Texas Association of Health Plans, a group that represents the insurance industry. She explains that some medical facilities are covering the costs of COVID tests under the federal mandate.
“These pricing schemes are just becoming ridiculous. Like I say, this one’s easy to understand because we all know this test shouldn’t be up more than $150,” Jamie explains.
When we stopped by Memorial Village ER, grandmother Gabriela Schell was being turned away for a test.
“They asked me what insurance I have and when I said Medicare, they immediately said, ‘Well, we don’t take Medicare. It will be $150.’”
That’s right. $150 for private pay patients to get the same test they billed United $3,752 in Jorge’s case. Medicare and Medicaid reimburse providers between $31 and $100 for COVID tests, but this ER won’t even accept that.
“It’s very dishonest and unequal,” said Gabriela. “I need a COVID test. I’m a senior and I really do need a COVID test.”
Jorge’s insurance company paid $958.25 for the claim. Meanwhile, Memorial Village ER and other freestanding ER’s like this one we investigated last fall are charging much more.
In our KPRC 2 investigation from earlier this year, we talked with one customer who took a test, and her insurance was later billed $8,900. Investigator Amy Davis tracked down CEO Dr. Hortencia Luna-Gonzales to ask about those charges.
“I’m wondering if you would explain why you would charge almost $9,000 for a COVID test?” asked Amy.
“We don’t charge $9,000,” said Luna-Gonzales.
“This is what you billed the insurance company,” said Amy.
“No comment. I’m gonna go,” Luna-Gonzales said.
Part of the billing problem is that sometimes insurance companies don’t even realize they are being billed for a COVID test, and they may have no way to know unless you tell them. If you notice excessive charges on your explanation of benefits let your insurance provider know so they don’t pay more than they have to because, in the end, we’ll all pay in increased premiums. Depending on your exact billing problem, you can also file a complaint about your insurance company with the Texas Department of Insurance.
New law makes COVID testing price gouging illegal
KPRC 2 Investigates is also following what is being done to protect consumers from high COVID testing bills. State lawmakers passed a new law that makes price gouging for tests and vaccines during the pandemic illegal.
The new law and enforcement of it are complaint-driven. That is why you should file a complaint any time you see freestanding ERs price gouging for COVID tests or vaccines. KPRC 2 Investigates explains how to file a complaint and the penalties for breaking the law here.
Free COVID testing near me
There are many options for finding free COVID testing near you. The only catch is that for some of the free tests, you do have to wait a little longer for results. Drive-thru testing for COVID-19 is available throughout Houston and across the state, according to the Texas Department of State Health Services. Many sites offer free testing, while others require payment or health insurance. You can also check for free testing sites with Harris County Public Health.
The company Curative has COVID testing kiosks all around the Houston area. The tests are free. You drive up to the kiosk, take the test, and you should get results in one to two days. You can find a Curative location near you by using this map.
FULL STATEMENT - Memorial Village ER Statement Regarding COVID-19 Test Billing
“Memorial Village Emergency Room’s billing practices are in strict compliance with all state and federal laws. Under the 2020 CARES Act, the federal government requires health insurers to pay for the costs for COVID-19 tests without passing on costs to patients. Insurance companies pay for a fraction of the bill, hospitals/clinics waive any patient sharing costs, like copays and deductibles, and patients are not responsible for the balance of the bill.
Memorial Village ER doesn’t directly charge insured patients for COVID-19 tests. Most insurance companies will cover a fraction of the billed amount. Coverage varies with companies like Ambetter paying $68 on the total bill.
Our rates and fees are comparable to, and less than, hospital emergency rooms and invoice charges represent a starting point for negotiating fair reimbursement for in and out of network insurance plans.”
