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Free corona tests: Medical association and health insurance companies hope for agreement soon

At least for high-risk patients, the costs should be covered by the health insurance company. A proposal from the Medical Association is currently being examined. Negotiations have been going on for months.

There is still no negotiated solution for corona tests, which have been subject to a charge at the doctor’s since April 1 (even in suspected cases). The basic aim is for the health insurance company to cover the costs, but only for high-risk patients. The sticking point is the level of the fee. A proposal from the Medical Association is now being “examined” by the umbrella organization of social insurance, the association said on Friday, and they hope to reach an agreement soon.

Back in May, Medical Association Vice President Edgar Wutscher pointed out that, for the benefit of patients, we had to be prepared for the fall, as a renewed increase in cases was expected. Such an increase has now already begun over the summer – earlier than in 2023, as a look at the Covid wastewater data shows (available here.)

No longer free since April

The negotiations have been dragging on for months: since April, the federal government has no longer covered the costs of the antigen tests. Even then, it was planned that a solution would be found via social insurance. Such a solution had originally been announced for mid-April: on April 2, the chairman of the Conference of Social Insurance Institutions, Peter Lehner, had already announced after a round of negotiations with the Medical Association that a solution would be presented “in around 14 days”.

Most recently, in mid-July, it was announced that a solution had been worked out and would now be voted on in the committees. The chairman of the Conference of Social Insurance Institutions, Peter Lehner, explained in a written statement to the APA at the time that the “latest date” for presenting a solution would be the beginning of August. Vice President of the Medical Association Wutscher also spoke at the time of “timely finalization”.

The tests were free for those suspected of having corona in the doctor’s offices until the end of March, and the federal government covered the costs until then. A positive corona test is a prerequisite for high-risk patients to be entitled to the antiviral drug Paxlovid. At the moment, a Covid test is offered by the doctor to his patient as a private service. A reimbursement of five euros per test can be claimed from the health insurance company.

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