When COVID-19 Testing is Covered
- Diagnostic tests for COVID-19: Covered with $0 cost share if you have symptoms or have been exposed to someone with COVID-19 and you or your health care provider decide you need a test. These are tests that are administered by a health care provider and processed in a lab and are different than the at-home OTC tests.
- Test needed before a surgery or medical procedure: Covered with $0 cost share. Your health care provider will tell you where you should get a pre-surgical test.
- Tests needed for screening purposes (return-to-school or work; travel; events). Not covered. Please read “When COVID-19 Testing is not covered” for important information.
This short video explains the difference between diagnostic and antibody testing.
Where to get a diagnostic test
- Contact your primary care provider’s office first.
- Testing is available at New York State or county testing sites, pharmacies, some doctor’s offices, urgent care centers, and participating hospitals.
- Erie County Testing Sites:
The ECDOH testing locations offer PCR and rapid testing. For more information, including locations, hours of operation, guidance on which type of COVID-19 test is recommended and when to test, visit the ECDOH COVID-19 Testing website or call the ECDOH COVID-19 Information Line at (716) 858-2929.
- New York State Testing Sites
- Other Counties: Check your county's health department website.
When COVID-19 Testing is not covered:
Independent Health does not cover COVID-19 testing for screening purposes, such as:
- Test required by an employer, or to attend school (both students and staff) if the individual does not have symptoms or has not been exposed to COVID-19.
- To attend events such as weddings, sports games, concerts, camps and other entertainment.
- Tests needed for travel purposes (domestic and international, including Canada).
- To participate in a sport or team activity.
- Public health surveillance.
Members of our self-funded plans should contact us at (716) 631-2661 or 1-800-257-2753 for specific information about how their plans cover testing. The back of your member ID card indicates “Medical benefits administered by Nova.”
Where to get tested for screening purposes
- Find a testing site
- Phone numbers: New York State testing sites at 1-888-364-3065; Erie County residents: Call 716-858-2929
- Residents of other counties: check with your county.
Testing Information for School Students and their Parents or School Staff
Many schools now have testing on-site for students and staff. Contact your school district to see if this is available, or with local pharmacies and your doctor.
Erie County residents: the county offers rapid PCR testing accepted by schools. Call 716-858-2929 to make an appointment.
Drive-up testing at Walden Galleria Mall
As a way to give our members an additional testing location, Independent Health has partnered with Kaleida Health Laboratories to offer drive-up COVID-19 testing at the Walden Galleria. We encourage you to take advantage of this testing location.
- Independent Health members are welcome to use drive-up COVID-19 testing by the Kaleida Health Laboratories at the Walden Galleria Mall. The testing site is in the former Sears’ Auto Center.
- Appointments are required before visiting the testing site. Make an appointment.
Members of our State products (MediSource, Essential Plan, Child Health Plus) must use participating in-network provider for these services. (These products follow specific coverage guidelines).
Coverage for Antibody Testing
Antibody testing with an order or prescription from your health care provider is covered. (While CMS regulations do not require a provider’s order for Medicare Advantage members, we encourage providers to discuss the benefit of the test with those members.)
Test to Treat Program
COVID-19 Oral Antiviral Treatments and the Test to Treat Program
While vaccines continue to provide the best protection against COVID-19, oral antiviral treatments are now available to help treat eligible people who do get sick.
- The Federal Government has created a Test to Treat program that provides better access to COVID-19 treatment using oral antiviral pills, such as PAXLOVID (nirmatrelvir tablets; ritonavir tablets) and LAGEVRIO (molnupiravir).
- At this time, the test-to-treat locations are limited locally. However, individuals may also obtain oral antiviral medications from other locations that are not part of the test-to-treat program. They need to obtain a prescription from their health care provider which will require a positive COVID test at the discretion of their health care provider.
- Individuals may be tested and treated by their own healthcare providers who can appropriately prescribe these oral antivirals at locations where they are being distributed.
- The medications are currently authorized for the treatment of mild-to-moderate COVID-19 who are at risk for progression to severe COVID-19.
- Members should check with their healthcare professional regarding whether they fall into that category and to assess if they have any other conditions that would preclude use of the antivirals.
Eligibility and Cost
Members with a commercial (employer or individual/group), state or Medicare plan can obtain treatments through Test to Treat at no cost. (Self-funded members should check with their plan administrator).
Test to Treat Resources, Locations, Information
For full details, including the process and where to find the participating locations, visit the Test to Treat government website.