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. 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 do not diagnose a current infection. 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. We also don’t know how long that protection might last, or if someone with antibodies is still contagious. Blue Shield and Blue Shield Promise will not cover antibody tests unless ordered by a healthcare provider licensed to order COVID-19 tests.

 

Who can get tested?

Call your healthcare provider if you have symptoms of COVID-19 or think you have been exposed to someone with COVID-19. If your healthcare provider decides that a test is needed, they will tell you where to get tested. Symptoms of COVID-19 include fever, cough, shortness of breath, or other symptoms. 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.

If you are an essential worker as defined by the Department of Managed Health Care (DMHC), you can get tested for COVID-19 even if you have no symptoms and have not been exposed to COVID-19. Note that this applies only for members enrolled in DMHC individual, 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, see Where can I get a test? for details. You can also contact Blue Shield and ask about your options for being tested. Also, you may be required to pay a copay, coinsurance, or deductible for your test. Essential workers who have symptoms or exposure may also get tested by contacting their healthcare provider as described above. 

 

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. It is advised that you take a test 8 days after exposure if you continue to have no symptoms, or 3 days after onset of symptoms. Your healthcare provider can help determine when you should be tested.

If your diagnostic test for COVID-19 is negative, it means that you probably were not infected at the time you were tested. But that does not mean you will not get sick or that you are not contagious. The negative test result just means that you did not have COVID-19 at the time of your test. You might test negative if you tested early in your infection and test positive later during your illness. You could also be exposed to COVID-19 after the test and get infected.

 

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.

If you:

  • 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
  • Education

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:

  • Retail
  • Manufacturing
  • Agriculture
  • Food manufacturing

Read additional details from the DMHC.

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Why can’t everyone get a test?

Limited testing supplies are available. The California Department of Public Health has developed strict guidelines to help providers determine when a test is appropriate. Those guidelines include priority groups until the state can expand access to testing. Priorities include:

Tier 1

  • Hospitalized patients with COVID-19 symptoms
  • Investigation and management of outbreaks, including contact tracing

Tier 2

  • All other people with COVID-19 symptoms
  • People who have been exposed to someone with COVID-19. This includes close contact with confirmed cases
  • People without COVID-19 symptoms in the following categories:
    • Residents in group living facilities
    • Healthcare workers who have frequent interaction with people with COVID-19
    • Workers in group living facilities and in-home support services
    • Caregivers for the elderly or people with disabilities who provide care in the home
    • Workers in the emergency service sector who have frequent interactions with the public or people with COVID-19. This includes first responders and other public service employees
    • Workers in correctional facilities
    • Hospital admission and discharge patients.

Tier 3

  • Essential workers without COVID-19 symptoms. These include people who have frequent interactions with the public or who work in an environment where it's not practical to maintain six feet of space from other workers. These include workers from the following sectors:
    • Retail or manufacturing
    • Food services
    • Agricultural or food manufacturing
    • Public transportation
    • Education (including those who have frequent interactions with students)

Read additional details on the California Department of Public Health’s defined priority list.

 

How can I get tested?

If you have symptoms or think you 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.

A symptom flowchart to determine whether or not you should get tested for COVID-19 in English

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 as defined by the DMHC and are enrolled in a DMHC individual, family, or group plan, see Where can I get tested?. Or, contact Blue Shield and ask about your options for being tested. Members who fall into this category 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.
  • If you do not fall into one of the essential worker categories as defined by the DMHC, tests will not be covered by Blue Shield and Blue Shield Promise without a healthcare provider order. And, 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 are an essential worker getting tested without a healthcare provider order.

If you have symptoms or have been in close contact with someone with COVID-19, contact your healthcare provider’s office to determine whether a test is needed. If a test is needed, they will direct you to a network location for testing.

If you are an essential worker without symptoms or a known or suspected exposure, you can visit a testing location at one of the following pharmacy or state testing locations:

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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.

 

What do I do if I test positive?

Speak with your healthcare provider about the next steps for care. Read more about getting care.