Corona: If free PCR tests are denied
According to experts, different groups of people are entitled to a free PCR test under certain conditions. This can also apply to people with no symptoms. But what to do if such a free test is denied?
In the corona pandemic, PCR tests are the most reliable tests. They should always be used if there is a suspicion of an infection with the SARS-CoV-2 coronavirus, for example due to symptoms of the disease or due to contact with infected people. The costs for a test will be covered if the responsible doctor or the health department approves it, it says on the website the federal government. But what to do if a free test is denied?
Claim according to the valid test regulation
Corona tests have long ceased to be in short supply – but getting a PCR test as a free service is sometimes difficult or even hopeless, writes the Rhineland-Palatinate consumer center in a current issue Message.
And this although certain groups of people are entitled to it – for example, if they are going to be hospitalized or have in-patient rehabilitation measures.
This is what it says in the current test regulation of the federal government, and this is how the Federal Ministry of Health has now also confirmed it to the consumer centers in North Rhine-Westphalia and Rhineland-Palatinate.
Consumers from various federal states have complained several times that, despite the clear legal situation, they have not found any doctors who will settle the PCR test with the Association of Statutory Health Insurance Physicians.
In most cases, it was about tests that are required before entering into inpatient rehab or before hospital admission – and which the practices only wanted to provide as a self-pay service.
A patient from Rhineland-Palatinate, for example, was fobbed off in two practices and in a test center.
Because the local statutory health insurance association had issued a circular to the medical practices in their district recommending that in these cases only a rapid antigen test be offered as a free service and, if necessary, the desired PCR testing performed as a self-payer service.
“It doesn’t work like that,” explains Tanja Wolf, head of the “Health Advertising Fact Check” project at the consumer centers in North Rhine-Westphalia and Rhineland-Palatinate Message.
“It is true that, according to the coronavirus test regulation, patients who have already been admitted can be referred to the rapid antigen test, so they do not receive a free PCR test,” said the expert.
“For those who still have hospitalization or rehabilitation ahead of them, stricter precautions apply due to the risk of carrying the virus into the facility from outside. This is also what the national test strategy of the Robert Koch Institute provides. “
A benefit to be reimbursed
The Federal Ministry of Health (BMG) has now confirmed the legal opinion of the consumer association in a letter. Prior to inpatient rehab or hospitalization, PCR tests are therefore a service to be reimbursed by the Association of Statutory Health Insurance Physicians.
“Anyone who is entitled to a free PCR test should persist,” recommends Tanja Wolf. According to the Robert Koch Institute (RKI), this includes not only people with severe corona-typical symptoms, but also, for example, people without symptoms who have had close contact with a person infected with the corona virus.
“If a practice does not want to bill the test as a statutory medical service, but only as a self-payer service, those affected should refuse and report this to the responsible consumer center,” advises Tanja Wolf.
“The consumer advice centers are happy to forward the cases to the responsible associations of statutory health insurance physicians and, if necessary, to the Federal Ministry of Health.”
Who should have PCR tests performed
According to the RKI, PCR tests should be performed for the following groups of people without symptoms:
- People who have had close contact with a person infected with the coronavirus, for example conversations lasting at least 15 minutes or direct contact with infected body fluids.
- People who have received a warning with the information “increased risk” from the RKI’s Corona warning app.
- People who work or are present in facilities such as doctors ‘surgeries, daycare centers, schools or asylum seekers’ homes, if an outbreak has been detected.
- Patients before (re) admission to a hospital or a rehab facility, as well as during outpatient operations or before outpatient dialysis.
- People in need of care, prior to admission to a care facility, including a one-time repeat test.
- People with a positive rapid antigen test.
- All persons in need of care, employees and those present in the event of outbreaks in health or care facilities.
Author and source information
This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.
This article is for general guidance only and is not intended to be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.