COVID Test for Hawaii "fee" with insurance

  • Hi,

    So Walgreens is a provider of the approved tests Hawaii requires to enter the state. They advertise “$0 cost”, but in reality, they are billing your insurance company for the visit and it’s up to your insurance company to decide whether the test was medically necessary.

    I live in CT, where we are spiking again. I realize the test, from a trusted provider, for travel will likely be deemed “non-essential”.

    In reading further, it says that they bill the insurance company $129 for the test. I attempted to get a straight answer from Anthem as to what to expect, but the agent wasn’t helpful in getting a definitive answer based on the explanation of benefits and ultimately said I “might” be billed unless a doctor ordered the test.

    So, do people really call their doctor, pay a co-pay for the doc to order a test, just to avoid this fee? Seems like a huge unnecessary waste of resources and I’m sure my regular doc has better things to do than make an appointment with me for this (they do in-person, Anthem, I was told doesn’t cover telehealth any longer).

    If it’s $129, I’m fine with that – just don’t know what to expect. I’ve read some reports online that bills were outrageous vs. others that said they never received a bill.

    Didn’t know if anyone had any recent experience?


  • Since I’ve never even visited Hawaii take this response for what it’s worth! My experience in New Mexico was the polar opposite of what you outlined. I registered with a State site and received a notification appointments were available and how to schedule. Once scheduled I arrived at the location and literally walked in and gave them my name and Date of Birth, sat down and they injkected my vaccine. They also gave me the card showing brand and date of injection. At the time I was waiting, 15 minutes in my case, I received my appointment for the second injection. At no point was I asked about insurance. I’m not so naïve that there is enough information traded around that “they” could not have found my insurance and/or Medicare information if they chose to.

    As I understand it the Federal Government is paying for the Vaccine however this link indicates this:
    Vaccine providers can be reimbursed for vaccine administration fees by patients’ public or private insurance companies, or by the Health Resources and Services Administration’s Provider Relief Fund for uninsured patients.

    So it’s somewhat sad that the folks in Hawaii are inclined to put people through hoops just to receive the vaccine. Good Luck.

  • Thanks Rick… This is a bit different in that it’s not about the vaccine, but a test from a “trusted partner” that Hawaii authorizes the tests from. There are a lot of free tests at home, but sadly, they are not trusted partners despite them being the same tests that Hawaii requires.

    It seems like insurance will be billed from the “trusted partner” test, but it’s up to the insurance company as to whether they’ll accept the claim or bill me.

    Thanks for the help and stay well!

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    @jokerzwild I work in a doctor’s office. People call us telling us that they want to be tested and we order the test without seeing them IF they are established patients in the practice and have been seen in the past year.

  • @my4mainecoons thanks!! That helps out a lot. Do people just ask generically like “I’d like to get a covid test at Walgreens” for example, to avoid the “for travel” purposes portion
    Thanks again!!

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    @jokerzwild We order the test (electronically) to be done at our local hospital. We don’t order tests at pharmacies.

  • @my4mainecoons gotcha… ok, not sure that’ll work as Hawaii requires specific travel partners for their tests to be performed, surprisingly hospitals are not considered part of the group, only very specific places and CVS/Walgreens. Might call the office and ask anyway… thx!

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    @jokerzwild My guess is that tests being done at pharmacies are low priority tests. I know they just collect the tests and ship them out.

    Our hospital collects the tests and sends them out also but the reason for the test determines which lab gets the swab.
    If someone is sick and being admitted to the hospital the results are back the next day.
    If someone is going into the hospital for a planned surgery the results are back in 2 days.
    If someone has been exposed the assumption is that the person is self-quarantining and results are back in 4 days.
    Some people wanted to be tested before Christmas so they could get together with family. Their tests were back in 4-5 days during which time they were supposed to be quarantining.

    No offense but I’m sure travel to HI is considered low priority. Some insurances don’t cover stuff like shots required for travel because its not medically necessary. Its like Plastic Surgery. Skin grafting because of a bad burn is covered. Chin tucks are not.


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