Quest Diagnostics has launched an at-home diagnostic test for COVID-19 that individuals can order online, but the out-of-pocket cost for the test could get in the way of widespread use.
The test, which is a nasal swab test permitted by the U.S. Food and Drug Administration under an emergency use authorization, enables customers to take a sample at home using a collection kit mailed by Quest and send the sample to the lab through FedEx.
Customers can also take the collection kit to one of 500 Walmart drive-thru pharmacy locations to use the test under a pharmacist's supervision and drop it off for delivery. Quest said test results are typically available in about two days.
After the customer purchases the test online, a licensed physician will determine if the test is appropriate and place an order. The company said the test is appropriate for people with COVID-19 symptoms or those who have been exposed to the someone with the condition.
The company is charging $119 for the test, plus a $9 physician fee. The cost would likely come out of the patient's pocket, as Quest said it will not submit the charges to a health plan or the federal government for reimbursement, and it will not provide customers a receipt with basic information normally required by health plans for reimbursement.
Under federal law, private insurers, Medicare and Medicaid must cover COVID-19 tests without any cost-sharing when the test is deemed medically necessary by a physician. Quest did not answer questions as to why it won't submit the charges to health plans.
A spokesman for the company said the individuals who may be interested in the test are those who don't want to use their insurance or don't want to leave their homes.
To be sure, consumers may find the at-home test to be a convenient alternative to potentially having to travel a long distance or stand in long lines for a test, where a person could infect others, said Sabrina Corlette, a health insurance expert at Georgetown University. The price tag could also be cheaper than going to an emergency department or urgent care clinic to be evaluated by a healthcare professional, she said.
Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, said the test may be attractive to the uninsured, or to insured people who have an incentive for testing that is not considered medically necessary. For instance, a person who has no symptoms and has not been exposed to COVID-19 may still want a test before returning to work or visiting a a family member with a new baby. However, she noted that the price point is "daunting" for many.
"A goal would be to make this kind of testing available to everyone in a way where cost was not a barrier, because public health experts have repeatedly said that we are way below our recommended level of testing," Hempstead wrote in an email.
Quest's diagnostic test is available in all states but Alaska, Arizona, Hawaii and Oklahoma, according to the spokesman. It is not available to people under the age of 18. An order for a test may be declined if all of the following do not apply: the person has symptoms of COVID-19; the person lives or works in a place where people are in close proximity; the person has been exposed in the past14 days; and the person has been asked to get the test by an employer, public health official, contact investigator or healthcare provider.
Quest said physicians will be available through telehealth to help customers understand their results and refer them to appropriate care. Quest previously launched an at-home COVID-19 antibody test in April.