COVID-19 Testing

A female healthcare professional gives instructions to a male colleague as they work at a COVID drive through testing site.

If you have symptoms of coronavirus (COVID-19) or were exposed to COVID-19, call your doctor. Your doctor will follow guidance from the state department of health to determine whether it’s recommended that you get tested.

If you go to an in-network doctor to get tested for the coronavirus (COVID-19):

  • Your diagnostic test and in-person visit to diagnose COVID-19 will be covered by your plan. There will be no cost-sharing, including copays, coinsurance, or deductibles.
  • CVS Pharmacy Minute Clinic® offers no-cost COVID-19 testing by appointment throughout the region. Visit their COVID-19 testing page to schedule a test.
  • AdvantageCare Physicians takes care of the whole you, including testing for COVID-19. To learn more, visit ACPNY’s COVID-19 testing page.

If you go to an out-of-network doctor to get tested for the coronavirus (COVID-19):

  • Your diagnostic test and in-person visit to diagnose COVID-19 will be covered by your plan. This includes any doctors outside of our network. There will be no cost-sharing, including copays, coinsurance, or deductibles. Treatment should still be obtained at a facility in our network, unless it is an emergency. If you are admitted to a facility not in our network, your treatment may NOT be covered by your plan. All normal coverage restrictions and cost-sharing charges will apply for care or treatment, including inpatient hospital admissions. Some plans do not cover out-of-network services, so this could include the total cost for services.

If you go to the emergency room to be tested for COVID-19:

  • Your diagnostic test and visit to diagnose COVID-19 will be covered by your plan. There will be no cost-sharing, including copays, coinsurance, or deductibles. Services you get for an emergency room visit will always be covered, if you are admitted to the hospital.

Food and Drug Administration (FDA) approved COVID-19 home tests that you buy at a pharmacy or store without a prescription or order from a licensed health care professional are not covered by your plan. Most health insurance plans do not cover COVID-19 tests for reasons other than diagnosis or treatment by a health care professional.  For example, tests conducted for return to work purposes or travel are generally not covered. 

Most standard health insurance plans do not cover non-diagnostic tests for employment reasons (e.g., drug screenings). These tests will generally not be covered just for return-to-work purposes. EmblemHealth will only cover non-diagnostic antibody tests when these services are covered by your benefit plan. If your doctor thinks you have COVID-19, EmblemHealth continues to cover FDA-authorized COVID-19 tests without cost-sharing, including copays, coinsurance, or deductibles.