Under state and federal law, COVID-19 tests must be covered by insurance, and any provider that accepts coverage must also provide it for free to the uninsured. Results often take between three and five days. For Santa Cruzans who need it faster, there are local options, but the most convenient can cost up to $225.
CruzMedMo — one of the only providers of rapid PCR COVID-19 tests in Santa Cruz County — takes only walk-ins, has five-minute wait times, and sends out test results within hours.
The catch? The company doesn’t accept insurance, and the cost ranges from $80 for an antigen test to $225 for the gold-standard PCR (polymerase chain reaction) one. Patients are provided with a “superbill,” or a detailed invoice, and are left to chase after reimbursement with their insurance provider.
“It’s just convenient,” said CruzMedMo owner Andrew Lewis. “They don’t have to make an appointment and we’re not making people schedule appointments. And so it sort of feeds into this Amazon expectation where ‘I want my free delivery and I want it in 48 hours,’ and we’re trying to deliver on some of that in health care.”
Given the newly discovered Omicron variant of the virus that causes COVID-19, Lewis said he expects a surge in individuals wanting a test. As of Friday, there were no known cases of the variant in Santa Cruz County, according to county spokesperson Jason Hoppin.
“It will drive people to just want to go and get tested,” Lewis said. “They want to be tested now and they don’t want to wait. People are wanting to operate outside the channels that are insurance-driven, and here’s a pathway.”
Lewis said that in August, amid the spread of the Delta variant, about three-quarters of CruzMedMo’s clientele were travelers. Now, he says it’s a 50-50 split between symptomatic patients and travelers, although this week where he’s seen an increase in travel testing for the upcoming holidays.
“We were meeting a need for travel requirements and people needed that test immediately within 72 hours,” Lewis said. “And no one else could promise that they could get it to you in a few hours.”
But that might not entirely be the case. Monterey-based Lightspeed Testing also provides rapid antigen and PCR tests without an appointment and gives same-day results — and does it for free through insurance. The catch? It’s available only a few hours a week.
Lightspeed Testing pop-up sites in Santa Cruz
• Wednesdays: 1-3pm, Cedar and Lincoln Streets at the Downtown Farmers Market
• Saturdays: 9 a.m.-noon, Mission Street and Western Drive at the Westside Farmers Market
• Fridays: 7:30-9:30 p.m., 1535 Commercial Way at Moe’s Alley
As of now, Lightspeed Testing is available on Wednesdays, Fridays and Saturdays at various pop-up locations. CEO Sameer Bakhda said he hopes to expand operations in Santa Cruz, but said a lack of staff and funding has made that difficult.
Lightspeed does take insurance, though it’s not always a smooth process.
“The thing about COVID testing is it’s all supposed to be free, or at least no cost for individuals,” Bakhda said. “There are a lot of testing sites out there that people are having to pay for, and then hope their insurance company reimburses them. So we came out with a different approach.”
That, however, has landed Lightspeed in debt, with some insurers refusing to pay the bill since the business is out of network.
“We’re kind of hoping that things work out, and I’m sure they will,” Bakhda said. “The waiting is hard. But we think it’s the right thing to do.”
Though it’s relatively rare in the Monterey Bay area, CruzMedMo is not the only business using the paid model. ARCpoint Labs, which existed before the pandemic, has franchises throughout the country and has adapted to offer COVID testing. Spenser Smith, lab manager of the Monterey ARCpoint branch, says the lab doesn’t accept insurance to avoid “regulatory burden.”
His company is one of a handful in that county that charges for the tests, another being Lifeline Health Services.
“It’s a very huge can of worms for us,” Smith said. “We were like a family business with five people working here and now we have a little less than twice that many people. We lack the capacity as a very small business to bring on an entire insurance billing unit.”
COVID-19 testing at ARCpoint in Monterey is in the same price range as CruzMedMo: $80 to $225, with results given the same day. Similar to CruzMedMo, ARCpoint provides clients with a detailed bill to aid their attempts get that money reimbursed.
But CruzMedMo’s Lewis said most of his customers don’t bother to file a claim.
“Some insurance companies will pay 100% of the cost, some of them will pay 50%,” he said. “So it’s really a wild card, and that’s one of the frustrations with just working with them.”