The third holiday season since the start of the pandemic is approaching and Covid remains a lingering presence. More than 300 people die from the coronavirus every day, on average, according to NBC News’ tally.
Testing remains a crucial tool for identifying cases and curbing the spread. But finding inexpensive tests and interpreting the results isn’t always straightforward.
Here are the latest guidelines from the Centers for Disease Control and Prevention and the Food and Drug Administration, along with expert advice, on how to get tests without paying out of pocket, check when a home test expires, and interpret a negative result if you have symptoms or known exposure.
Private insurance and Medicare cover eight home tests per month
Since January, the Biden administration has required private insurers and Medicare to cover up to eight home tests per month. Individuals with private insurance can order the tests from in-network pharmacies or submit reimbursement claims for tests they purchase from other stores or from out-of-network pharmacies. People with Medicare can search online for a list of providers that offer free testing.
PCR lab tests are also fully covered by private insurance and Medicare.
Free government home tests are no longer available
The federal program that distributed up to 16 free at-home tests to households by mail ended Sept. 2 due to a lack of congressional funding.
How to Find Free Testing Sites Near You
Some sites that provided free rapid or PCR tests earlier in the pandemic have closed, but the Department of Health and Human Services has an online search tool to find nearby sites still offering free or at-a-glance tests. low cost. Most locations are pharmacies like CVS and Walgreens, but the site may also direct you to your public health department’s website, which may offer additional options.
Once the government’s public health emergency declaration expires, testing costs will likely rise
The declaration was last renewed in October and could end in 2023. After that, Medicare beneficiaries will most likely have to pay the full cost of home testing, but should still have covered clinical diagnostic tests, according to KFF. , a non-profit organization. health think tank. For those with private insurance, testing costs will be subject to the details of their plans, but are unlikely to be fully covered.
Rapid tests may expire, but many shelf lives have been extended
Different tests have different shelf lives, but many of the original expiration dates have been extended since the tests were authorized.
In such cases, the manufacturer has provided evidence to the government that the tests give accurate results for longer than was known when they were created.
Abbott’s BinaxNOW home test, for example, says it has a 15-month shelf life, but many batches have had their expiration dates extended by three to six months. The government-distributed tests from iHealth Labs, meanwhile, last for a year, but most have had their shelf life extended by four to six months. Flowflex home tests have a shelf life of 19 months, with six month extensions.
To check if the expiration date for your particular test has been revised, click on the corresponding link on the FDA list and find the lot number.
When to test if you have been exposed or feel sick
If you have symptoms, get tested immediately. If you have been exposed to someone who has tested positive but you feel healthy, test after five full days.
The FDA recommends people with known exposure who test negative get a second test 48 hours later. If they are negative again, test a third time after another 48 hours.
“We know about antigen-based tests, you have to repeat them. These are not one-time tests,” said Dr. Susan Butler-Wu, associate professor of clinical pathology at the University of Southern California.
If you’re exposed within 30 days of testing positive for Covid, you don’t need to test unless you develop symptoms, according to the CDC. If less than 90 days have passed since your last Covid infection, use a rapid test, as PCR results can remain positive for up to 12 weeks.
What to know about the accuracy of home tests
PCR tests are generally more sensitive and accurate than home tests, but results can take at least 24 hours – and often days. Home tests (also called antigen tests), meanwhile, rarely give false positives but can give false negatives, even if someone is symptomatic. This is especially likely in the early days of an infection.
Scientists don’t know why. One theory is that the immune response drives symptoms before the virus has a chance to replicate to detectable levels. It can cause people to feel tired, achy, or sniffle before testing positive.
For other people, Covid tests never come back positive even though they feel sick and have been exposed to the virus. These people may have unrelated infections or their immune systems may have quickly overcome the virus before it replicated widely enough to register for a test.
Elderly or immunocompromised people should always seek PCR tests if they feel ill or have been exposed to Covid and test negative at home, said Dr. Sheldon Campbell, associate professor of laboratory medicine at the Yale School of Medical. This is because these groups are eligible for treatments like Paxlovid within days of testing positive.
“You don’t want to wait two days, get a positive result and realize you should have treated for two days,” he said.
Your test result could be a good indicator of contagiousness
Campbell said a positive test on a home test is a pretty good indicator that you are contagious. But Butler-Wu warned that it is still possible to be contagious and test negative on a home test or to test positive and not pass the virus on to others.
“At the end of the day, there is no infectivity test for Covid. There never was and there still isn’t,” she said.
However, it is well established that people are more likely to be contagious early in their illness. A study from August found that 65% of people with Covid cleared the infectious virus five days after their symptoms started, but only 24% were still doing so after a week.
How soon you are likely to test positive
If you are mildly ill, the CDC recommends isolating for at least five days after you test positive or symptoms start, then end isolation if you test negative or symptoms resolve or disappear. If your symptoms haven’t improved much or you still have a fever on day five, the agency advises continuing isolation until you’ve been fever-free for 24 hours without medication.
People with moderate or severe illness – characterized by shortness of breath or hospitalization – should self-isolate until day 10.
“Typically, people are positive for about seven days after their symptoms start,” Campbell said. “Some people can go longer – rarely more than two weeks.”
In one small study, only 25% of people with Covid tested negative on rapid tests on day six of their illness, but all participants tested negative after two weeks. In a study of college athletes with Covid, meanwhile, 27% still tested positive a week after their first positive tests.
Campbell said scientists are still investigating why some people test positive for longer than two weeks.
“People who test positive for antigen beyond two weeks somehow don’t have good immunity to the virus,” he said.