What types of tests are available? And what’s the difference?
There are two types of tests available for COVID-19:
- Diagnostic tests tell if someone has a current infection and is contagious. These tests are done by either spitting into a cup or having a swab inserted into the nose or throat. There are two kinds of diagnostic tests: laboratory-based tests and point-of-care tests (also called rapid tests). Laboratory tests take longer but are more accurate.
- Antibody or serology tests measure the presence of antibodies in the blood. These indicate if you had a previous infection but cannot tell if you have an active infection at the time of the test. These tests require blood to be drawn.
I’ve heard there are concerns about antibody tests. What are those concerns?
An antibody or serology test generally cannot show if there is a current infection. This is because it can take 1 to 3 weeks after infection to make antibodies. They are not appropriate for diagnosis of a current infection.
Also, we do not know yet if having antibodies to the virus or a positive result can protect someone from getting infected with the virus again. If there is protection, we also don’t know how long that protection might last, or if someone with antibodies could still be contagious. Blue Shield will not cover antibody tests unless ordered by a healthcare provider licensed to order COVID-19 tests (and for a rare case in which it is needed to help make a diagnosis).
Who can get tested?
1. All members who have symptoms of COVID-19 or have been exposed
Call your healthcare provider if you have symptoms of COVID-19 or think you have been exposed to someone with COVID-19.
- Symptoms of COVID-19 include fever, cough, shortness of breath, or other symptoms.
- If your healthcare provider decides that a test is needed, they will tell you where to get tested.
- During the public health emergency, if your healthcare provider orders a test, you will not have to pay any copay, coinsurance, or deductible for that test.
2. Members who are essential workers and have NO symptoms of COVID-19 and have NOT been exposed
If you are an essential worker as defined by the California Department of Managed Health Care (DMHC), you can get tested for COVID-19 even if you have no symptoms and have not been (or don’t suspect you have been) exposed to COVID-19.
- You will be required to pay a copay, coinsurance, or deductible for your test.
- Remember: Essential workers who have symptoms or exposure may also get tested by contacting their healthcare provider as described above.
- Essential worker testing applies only for members enrolled in individual and family and group plans. It does not apply to Medicare, Cal MediConnect, or Medi-Cal plan members (no Blue Shield Promise members). It also does not apply to members enrolled in employer-sponsored, self-funded plans.
- If you fall into this category and want to be tested:
- Essential workers should check this webpage often for updated information.
Read the most up-to-date details about state guidelines for priority group testing on the California Department of Public Health’s defined priority list.
How do I know if I’m an essential worker?
The DMHC says you are an essential worker if you meet any of the criteria below.
- Work in correctional facilities
- Work in a group living or congregate care facility, i.e. residential care facility or homeless shelter
- Provide care in the home to an elderly person or person with disability
If you work in one of the sectors below AND regularly have contact with the public or with people who may have or been exposed to COVID-19:
- Health care
- Emergency services
- Public transportation
- Food services
If you work in one of the sectors below AND have frequent interactions with the public or can't regularly maintain at least six feet of space from other workers:
- Food manufacturing
Read additional details from the DMHC.
When should I get tested?
Timing for testing is important. The incubation period for COVID-19 is around 5 to 7 days. But it can be up to 14 days. If you have symptoms, it is advised that you take a test 3 days after symptoms develop. If you have been exposed to COVID-19 but have no symptoms, it is advised that you take a test 4 - 8 days after exposure. Testing too early or too late is likely to result in a negative test even if you have been infected. Your healthcare provider can help determine when you should be tested.
If I test negative, does that mean I don't have COVID-19?
If your diagnostic test for COVID-19 is negative, you could still have COVID-19 if the test was taken too early or too late in the infection. The negative test result just means that you probably did not have COVID-19 at the time of your test (additionally, sometimes the test can be wrong). But that does not mean you will not get sick or that you are not contagious. You could also be exposed to COVID-19 after the test and get infected. Everyone needs to practice precautions even if they have had a negative test.
What do I do if I test positive?
Speak with your healthcare provider about the next steps for care. Read more about getting care.
How can I get tested if I have symptoms or think I have been exposed to COVID-19?
Speak with your healthcare provider first. Your healthcare provider can help determine if you need a test. Sometimes symptoms are mild and can be treated at home. Your healthcare provider will let you know where to get a test, if needed. They will determine the best course of action for your care.
How can I get tested if I have no symptoms and don’t think I have been exposed to COVID-19?
If you have no symptoms and have not been exposed to COVID-19, you may also get tested:
- If you are about to undergo a significant medical procedure. This testing will be covered when ordered by your healthcare provider.
- If you fall into one of the essential worker categories and are enrolled in one of the eligible Blue Shield individual and family or group plans, you have a few options:
- Order a home test kit that will be sent to you within 24 hours from LabCorp.
- Visit our customized Blue Shield home test ordering page.
- You must order your home test kit only from this page to ensure coverage.
- If you try to order a home test kit directly from the LabCorp or any other online lab using their general test kit webpage, you may be charged for the test and may pay more out-of-pocket.
- Find a list of testing locations under Where can I get a test?
- Contact Blue Shield and ask about your options for being tested.
- Essential workers with no symptoms or exposure may be required to pay a copay, coinsurance, or deductible.
- Blue Shield recommends that you visit a testing site in-network to keep your out-of-pocket costs low.
- Essential workers who have symptoms or exposure may also get tested by contacting their healthcare provider as described above.
- Order a home test kit that will be sent to you within 24 hours from LabCorp.
- If you do not fall into one of the categories above, tests will not be covered by Blue Shield without a healthcare provider order.
- You may be responsible for the full costs of your test if you don’t have a healthcare provider order.
- You may be able to get a free test without a healthcare provider order at a community testing site. Or, check state, county, city, or local public health department for options for free testing.
Where can I get a test?
Blue Shield recommends that you visit an in-network testing site whether you have a healthcare provider order or not.
I have symptoms or have been exposed
If you have symptoms or have been in close contact with someone with COVID-19, contact your healthcare provider’s office first to determine whether a test is needed. If a test is needed, they will direct you to a location for testing.
Teladoc is unable to order COVID-19 tests at this time. If the Teladoc provider suggested that you get tested due to your symptoms:
- Please contact your primary care physician (PCP).
- You can also contact a healthcare provider licensed to order COVID-19 tests.
Your test will be covered at no cost to you during the public health emergency with an order from your PCP or the other provider.
I have no symptoms or have not been exposed and am an essential worker
If you are an essential worker as defined above without symptoms or a known or suspected exposure, you have a few options:
- Blue Shield has negotiated with LabCorp to provide home test kits for essential workers.
- Order a home test kit from LabCorp that will be sent via overnight delivery.
- To qualify, you will be asked to complete a statement to confirm that you are an essential worker, at least 18 years old, and have no symptoms or known exposure.
- This order site should not be used for those with symptoms or known exposure, non-essential workers, or Medicare, Cal MediConnect, or Medi-Cal plan members (no Blue Shield Promise members).
- Visit a network testing location at one of the following pharmacies:
- Use the State testing locator to find a testing site. The location results from the State may include out-of-network sites.
If you are an essential worker and visit a network location and you don’t have a doctor’s order, you will have to pay an in-network cost share (copay, coinsurance, or deductible).
If you visit an out-of-network location, you will still pay cost share at an in-network rate. Plus you will be responsible for all other costs up to the billed amount. So your total out-of-pocket costs will be higher. Blue Shield recommends you choose network locations to save on out-of-pocket costs.
Read Coverage for COVID-19 testing FAQs to learn more about coverage. This can also tell you if you might have out-of-pocket costs.
Essential workers should check this webpage often for updated information.
I’m not an essential worker. My COVID-19 test is not medically necessary. What other options are available for free testing?
The state may cover the cost of your test if Blue Shield does not. This could apply if you have no symptoms, have not been exposed to COVID-19, and are not an essential worker. Find a testing site on the state list.
Check with your city or county public health department to find out if free testing is available without a healthcare provider’s order. There may be other testing sites available to help you at low or no cost.