Understanding COVID-19 testing and treatment coverage
At UnitedHealthcare, we're here to help you manage your health, understand what's covered and get access to the care you need. Remember to visit network health care providers and always show your UnitedHealthcare member ID card for COVID-19 testing or related services. Also, keep your primary care provider informed of any COVID-19 testing results, vaccinations or care you might receive.
Sign in to your online UnitedHealthcare account or review your plan materials for details on your benefits plan. You can also find a general summary of benefits for COVID-19 testing, testing-related services and treatment below.
Sign in to view your benefits
If you have been exposed to COVID-19 or have COVID-19 symptoms, call your health care provider right away. Use our online symptom checker to assess your risk for COVID-19 and get treatment options.
Looking for a testing center?
Talk to your primary care provider or other health care professional if you think you need COVID-19 testing. Use our testing locator to find a diagnostic testing center near you. Diagnostic tests can help you understand if you might currently have COVID-19.
Testing for COVID-19 is important to slowing the spread of COVID-19. We encourage you and your health care provider to use FDA-authorized tests. There are 2 types of COVID-19 tests:
- Diagnostic tests determine if you are currently infected with COVID-19. There are 2 types of these viral diagnostic tests: nucleic acid amplification and antigen tests.
- Antibody tests, also known as serology tests, may determine if you might have been infected with the virus. According to the FDA, antibody tests should not be used to diagnose a current infection.
Medically-appropriate COVID-19 tests have $0 cost-share during the national public health emergency period, currently scheduled to end Oct. 17, 2021. Medically-appropriate COVID-19 tests must be FDA-authorized or approved, and be ordered or reviewed by a health care professional to either 1) diagnose if the virus is present in a person due to symptoms or potential exposure, or 2) help in the treatment of the virus for a person. This coverage applies to in-network and out-of-of-network tests for Medicare Advantage, Exchange, Individual and Employer-sponsored health plans. For individuals enrolled in UnitedHealthcare Community Plans, state variations and regulations may apply during this time.
UnitedHealthcare health plans generally do not cover COVID-19 surveillance testing, which is testing used for public health or social purposes such as employment (return to workplace), education, travel, or entertainment. And like other over-the-counter health products, COVID-19 tests purchased over-the-counter—without a prescription or doctor’s involvement through a clinical lab—are generally not covered by your benefits plan. You will be responsible for any cost, and may use your health savings account (HSA), flexible spending account (FSA) or health reimbursement account (HRA). If your doctor or other health care professional provides a prescription or order for the over-the-counter COVID-19 test as part of clinical care, you may submit a claim for reimbursement with both the prescription and detailed receipt to UnitedHealthcare. State variations and regulations may apply.
If you think you might have COVID-19 or may have been exposed to the virus, talk to your network health care provider. If you have questions about your benefits plan, call the phone number on your UnitedHealthcare member ID card.
COVID-19 testing-related services
You will have $0 cost-share (copay, coinsurance or deductible) for COVID-19 testing-related services via in-person or telehealth visits during the national public health emergency period, currently scheduled to end Oct. 17, 2021. This coverage applies to in-network and out-of-of-network visits for Medicare Advantage, Exchange, Individual and Employer-sponsored health plans. For individuals enrolled in UnitedHealthcare Community Plans, state variations and regulations may apply during this time. Benefits will be reviewed in accordance with the member’s health plan.
If you get sick with COVID-19, your health care provider may prescribe treatments. For COVID-19 treatment, cost-sharing will be according to the member’s benefit plan. You will be responsible for any copay, coinsurance, deductible or out-of-network costs. This coverage applies to Medicare Advantage, Exchange, Individual and Employer-sponsored health plans. For members enrolled in UnitedHealthcare Community Plans, state provisions and regulations may apply during this time.
Outpatient monoclonal antibody treatment
The FDA has issued emergency use authorization for a number of monoclonal antibody treatments. According to the CDC, monoclonal antibody treatments may be recommended by your provider if you test positive for COVID-19, and are at risk to get very sick or to be admitted to the hospital. This treatment can help the body respond more effectively to the virus. If used, the treatment should be administered as soon as possible after diagnosis and within 10 days of symptom onset. Your health care provider will help determine if this treatment can help your body respond more effectively to the virus.
A summary of coverage for FDA-authorized monoclonal antibody treatment is below. Sign in to to your online UnitedHealthcare member account for more details.
- Exchange, Individual and Fully Insured Employer-sponsored plans: For monoclonal antibody treatment with network providers, cost-sharing will be according to the member’s benefit plan. You will be responsible for any copay, coinsurance or deductible. Coverage for out-of-network services will be determined by your benefit plan.
- Medicare Advantage plans: For monoclonal antibody treatments, you will have $0 cost-share with in-network and out-of-network providers in outpatient settings through 2021. You might need your red, white and blue Medicare card, because Medicare is paying for this treatment in 2021.
If you have questions about your benefits, sign in to your health plan account or call the number on your member ID card.
Support for our highest risk members
Members who are at high risk may be prescribed self-isolation by their provider. We're here to help those members through isolation and further limit their potential exposure to the virus. The UnitedHealthcare navigation support program provides a dedicated advocate to talk with you and help guide you through the isolation process. They can help you with how to get medications, supplies, food and care. You can also talk with them to learn about available support programs.
Members can access the program by calling the phone number on their member ID card. When you call, let them know your health care provider has prescribed self-isolation.
Based on currently available information from the CDC, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.
Get help to understand your benefits
If you have questions about your benefits, sign in to your health plan account or call the number on your member ID card. We can help you understand your coverage, find a health care provider or connect you with a nurse.
We’re committed to keeping you up to date on COVID-19. We're taking note of your questions and working hard to provide answers.