Last update: July 24, 2020, 12:10 p.m. CDT
UnitedHealthcare will cover COVID-19 testing for all lines of business, in accordance with the member's benefit plan.
A virus/antigen detection (diagnostic) test determines if a person is currently infected with COVID-19, while an antibody (serology) test may determine if a person has been exposed to COVID-19.
- Virus/Antigen Detection and Antibody Testing: During the national public health emergency period, UnitedHealthcare will cover medically necessary COVID-19 testing at no cost share when ordered by a physician or appropriately licensed health care professional for purposes of diagnosis or treatment of an individual member.*
Tests must be FDA authorized to be covered without cost sharing (copayment, coinsurance or deductible). FDA-authorized tests include tests approved for patient use through pre-market approval or emergency use pathways, and tests that are developed and administered in accordance with FDA specifications or through state regulatory approval.
This coverage applies to members enrolled in Medicare Advantage, Medicaid and Individual and Group Market health plans. Please do not collect upfront payment from the member. Benefits will be otherwise adjudicated in accordance with the member’s health plan. We will reimburse COVID-19 testing in accordance with applicable law, including the CARES Act and UnitedHealthcare’s reimbursement requirements. State variations and regulations may apply during this time.
Date Reference Guide: Keep track of which temporary measures are expiring and which are being extended with our Summary of COVID-19 Dates by Program.
- Rapid Point of Care Testing: UnitedHealthcare will cover FDA-authorized rapid point of care virus/antigen detection and antibody testing.
- COVID-19 Testing-Related Visits: UnitedHealthcare is also waiving cost sharing for COVID-19 testing-related visits during the national public health emergency period, whether the testing-related visit is received in a health care provider’s office, urgent care center, emergency department or telehealth visit. This coverage applies to Medicare Advantage, Medicaid, Individual and Group Market health plan members.
- COVID-19 Treatment: UnitedHealthcare is waiving member cost sharing for the treatment of COVID-19 through Oct. 22, 2020 for its Medicare Advantage, Medicaid, and Individual and Group Market fully insured health plans. We will also work with self-funded customers who want us to implement a similar approach on their behalf.
- Telehealth Services: UnitedHealthcare will waive cost sharing for in- and out-of-network telehealth services for medical, outpatient behavioral, PT/OT/ST, chiropractic therapy, home health, hospice and remote patient-monitoring services for Medicare Advantage, Medicaid, and Individual and Group Market fully insured plans. We will also work with self-funded customers who want us to implement a similar approach on their behalf. Learn More
UnitedHealthcare is also monitoring state-specific regulations related to the national public health emergency period. Other health care services while traveling will be covered in accordance with the member’s health plan benefits.
*Licensure requirements vary by state. In some states, a pharmacist or other health care professional, such as a nurse practitioner, may have the appropriate licensure to order a test. Please refer to state-specific licensure requirements for appropriate guidance.
An antibody test may determine if a person has been exposed to COVID-19, while a COVID-19 diagnostic test determines if a person is currently infected. FDA authorized tests include tests approved for patient use through pre-market approval or emergency use pathways, and tests that are developed and administered in accordance with FDA specifications or through state regulatory approval. According to the FDA, an antibody test should not be used to diagnose a current infection. Virus detection should be used to diagnose a current infection. UnitedHealthcare strongly supports the need for reliable testing and encourages health care providers to use reliable FDA-authorized tests.
Test Registration Requested
UnitedHealthcare is requesting all physicians and health care professionals who perform and bill for COVID-19 antibody tests to register the test(s) that will be used for our members. This includes both hospital-affiliated and freestanding laboratories, as well as physician practices with in-house laboratories. The registration takes just a few minutes to complete. You’ll need to complete it for each specific test you offer. (For example, if you have two different tests that are offered to physicians/patients, you’ll need to complete the registration twice.) If you change the test(s) you use in the coming months, you’ll need to complete the survey again.
Please complete the COVID-19 Antibody Test Registration as soon as possible. To complete the test registration, you’ll need:
- The laboratory tax ID number (TIN)
- The type of antibody test rendered
UnitedHealthcare will use the registration information to assist providers in choosing tests that are FDA authorized and to better understand the clinical reliability of the tests being used.
UnitedHealthcare is following the CDC guidelines, which recommend that a physician order the test. FDA-approved tests are sent to an approved laboratory that can properly test for the presence of COVID-19. Currently, there are no at-home testing or specimen collection kits available for patients.
There are currently three ways to order a COVID-19 test: Through a public health facility, commercial laboratory (e.g., LabCorp and Quest Diagnostics) or hospital. The commercial laboratory testing through LabCorp and Quest Diagnostics became available March 11, 2020. Additional laboratories – including local hospital systems – are also beginning to test.
If a care provider determines their patient needs a COVID-19 test, but is not able to conduct the test themselves, care providers should work with their local and state health department or an affiliated hospital to determine where their patients can go in their community to get tested. Depending on the patient’s identification, acuity and location, they may get any one of the approved tests. Care providers are encouraged to call ahead and work with their patients to take proper isolation precautions when referring them for testing.
Care providers should follow the guidance from commercial laboratories to help ensure that they properly collect and ship the COVID-19 specimens. For more information, review the CDC’s guidelines for COVID-19 specimen collection. Or, visit labcorp.com and/or questdiagnostics.com.
UnitedHealth Group released a study that shows self-administered tests are 90% effective and significantly reduce the risk of infection for care providers when collecting the tests. Currently, self-administered tests must be (unless using an FDA-authorized at-home collection kit):
- Ordered by a physician or health care provider (MD, DO, PA or NP), so clinics can register the test and help ensure chain of custody for the results
- Conducted in the physical presence of a health care professional to help ensure the collection is done the right way (e.g., the patient put the nasal swab far enough into their nose to collect an appropriate sample – can’t just touch the nose)
- Coordinated through local and state health departments for laboratory testing or use COVID-19 virus detection testing labs authorized by the FDA under the emergency use authorization act
We’re committed to keeping you up to date on COVID-19 – we’re monitoring your inquiries and working hard to answer your questions. Let us know how we’re doing.
We’ll be making daily updates to this site. Be sure to check back often for the latest information.
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The benefits and processes described on this website apply pursuant to federal requirements and UnitedHealthcare national policy during the national emergency. Additional benefits or limitations may apply in some states and under some plans during this time.
We will adjudicate benefits in accordance with the member’s health plan.
Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.