Surprise medical bills for treatments, tests, and other healthcare are all too common in the U.S.

Care for COVID-19 is no exception, according to a new survey by of 1,250 American adults.

Despite advertisements and assurances of free testing and vaccinations, 50% of Americans paid for at least one COVID-19 test administered at a health clinic, government site, or pharmacy, while 42% of vaccinated Americans report paying for their shots.

The fear of surprise medical bills is so pervasive that in some cases, it’s preventing Americans from seeking COVID-19 testing, vaccination, or treatment altogether.

Key Findings:

  • 2 in 5 vaccinated Americans were billed for their COVID-19 vaccines; 43% of those charged received a surprise bill
  • 68% of uninsured Americans paid for COVID-19 vaccines, compared to 34% of insured individuals
  • 1/3 of Americans skipped a COVID-19 test at least once because of concerns about cost
  • 28% of Americans avoided getting treated for COVID-19 because they were concerned about how much it would cost

43% of Americans charged for COVID vaccine say bill was unexpected

According to the Centers for Disease Control and Prevention, “COVID-19 vaccines are available for everyone ages 5 years and older at no cost.”

However, 42% of vaccinated Americans report paying for their COVID-19 vaccine. Among this group, 43% didn’t expect to be billed.

Meanwhile, for those who knew upfront they would have to pay for their vaccine, there was still a level of uncertainty. Thirty-five percent of these respondents didn’t know how much they would be charged until they received their bill.

Nearly 7 in 10 uninsured Americans had to pay for COVID vaccines

An individual’s health insurance status isn’t supposed to affect their access to COVID-19 vaccines, but according to our survey, it does.

Only 32% of uninsured Americans who received a COVID-19 vaccine got the shot for free compared to 66% of insured Americans.

Uninsured individuals are also twice as likely as those with health insurance to pay $50 or more for their vaccines (40% compared to 21%).

1 in 4 Americans don’t believe COVID vaccine is free

When asked about the validity of a statement, which read, “COVID-19 vaccines are free to all people living in the United States, regardless of their immigration or health insurance status,” 26% said it was false.

This confusion may also contribute to lagging vaccination rates. Forty-four percent of Americans who don’t believe the vaccine is free remain unvaccinated against COVID-19. Comparatively, 31% of Americans who believe the CDC’s statement about free vaccines aren’t vaccinated.

Half of Americans billed for COVID tests at health clinics, government sites

Americans who seek testing for COVID-19 at health clinics, government-run testing sites, or pharmacies may also get hit with surprise bills.

These are the most popular avenues for COVID-19 testing, with 53% of Americans saying they have gotten tested through one of these venues at least once.

However, half of Americans who were tested at a clinic, government site or pharmacy were charged for their test. Thirty-eight percent of those individuals weren’t aware they would have to pay for their test.

As with COVID-19 vaccines, even those who knew they’d have to pay for their test weren’t always aware of how much they’d be charged. Thirty-five percent of respondents who knew they’d be charged for a COVID-19 test didn’t know how much they’d have to pay until they received their bill.

One-third of Americans avoided getting a COVID test because of cost

The uncertainty and opacity of billing for COVID-19 tests resulted in a dangerous outcome. Thirty-one percent of Americans say that at least once, they chose not to get tested for COVID-19 because they were concerned about the cost.

Uninsured Americans are more likely than those with health insurance to choose not to get tested for COVID-19 because of cost concerns, by a rate of 46% to 35%.

For 42% of patients treated for COVID, bills came as a surprise

There were also surprises in store for the 31% of Americans who sought treatment for a COVID-19 infection.

Among this group, 70% of patients had to pay for their treatment, with costs being relatively similar among the insured and uninsured.

However, patients with health insurance were slightly more likely than those without to receive their treatment free of charge (33% vs. 26%).

Forty-two percent of those who paid for treatment didn’t know in advance they would be charged. Meanwhile 37% of those who knew they’d be charged didn’t know how much they would have to pay for their treatment.

28% of Americans avoided COVID-19 treatment because of cost, fear of surprise bills

Concerns about the cost of COVID-19 treatment–either known or unknown–prevented 28% of people from seeking healthcare after a diagnosis.

Fourteen percent of Americans didn’t seek treatment because of fear of being hit with a surprise bill, while another 14% say knowing upfront how much they would have to pay for COVID-19 treatment was a deterrent.


All data found within this report derives from a survey commissioned by and conducted online by survey platform Pollfish. In total, 1,250 American adults were surveyed. This survey was conducted on December 27, 2021.. All respondents were asked to answer all questions truthfully and to the best of their abilities. For full survey data, please email Content Marketing Specialist Kristen Scatton at [email protected].