As Oregon expands coronavirus testing, uninsured patients may struggle with access

An image of the coronavirus from the federal Centers for Disease Control and Prevention.

As Oregon scrambles to ramp up testing for the novel coronavirus, the nearly 248,000 Oregonians without health insurance could face bills for seeing a doctor or other providers to get tests ordered.

The test itself won’t pose a financial burden so long as government agencies are running testing.

If a patient meets criteria for testing, a doctor seek approval from the state to conduct the test, then swab the patient’s throat or nose. Samples are shipped to the Oregon State Public Health Laboratory in Hillsboro.

The swab and shipping cost just a few dollars, Salem Health spokesman Elijah Penner said.

Oregon pays about $350 per COVID-19 test, Oregon Health Authority spokesman Jonathan Modie said, but doesn’t pass that cost along to patients or clinics. The U.S. Centers for Disease Control is also testing patient samples for free.

As private labs enter the testing business, that could change.

For now, an uninsured person with symptoms of the disease still needs an order from a health provider to get tested – and that means a visit to a clinic or hospital which could cost hundreds of dollars or more out-of-pocket.

The state currently has no plans to pay for the cost of that care and is instead directing uninsured Oregonians to seek free or low-cost care. About 6% of Oregonians don’t have health insurance, according to OHA data.

Modie said the state encourages people without insurance to sign up for Oregon Health Plan, the state’s Medicaid program, which is free for low-income people.

Those without insurance who aren’t eligible or don’t want to sign up can seek testing through a county health clinic or one of Oregon’s 154 federally qualified health centers, which treat uninsured patients, he said. Those clinics typically charge varying amounts for care that depends on a patient’s income.

Most hospitals have charity programs that could provide care for patients unable to cover medical bills.

The CDC on Thursday published new provisional guidelines for health systems regarding testing for COVID-19 which would make more patients eligible for testing. Under the guidelines, a patient must demonstrate a clinical need for hospitalization, show evidence of a viral lower respiratory infection and have tested negative for influenza.

Earlier guidelines required travel to an affected area, close contact with a patient who had already tested positive or more serious symptoms of illness not explained by another diagnosis.

Oregon now intends to follow those expanded guidelines. State officials said earlier this week they did not have the capacity to test everyone covered by CDC criteria.

“If they meet these three things, their test will be approved,” Modie said. “This really streamlines the process for clinicians to get approval for a test at the state lab.”

Modie also said clinicians will no longer have to speak with an epidemiologist over the phone to get a testing request approved. The state has set up a new online process for health care providers to apply for a test, which will save time and help speed the process.

An agreement between Oregon insurance regulators and eight private insurance companies announced Thursday means many patients wouldn’t pay out of pocket if they seek testing for COVID-19. Several other private insurance companies, including Cigna and Aetna, on Friday announced similar programs nationwide.

The deal covers both the cost of the test and the cost of a visit to an in-network clinic, urgent care or emergency room to get tested. Patients would still pay for other tests ordered by a doctor, like an influenza test, or the cost of hospitalization or other care if it’s needed.

Sam Stites contributed reporting.

Contact reporter Rachel Alexander at [email protected] or 503-575-1241.