Jan 10, 2022 - Health

Insurers to cover costs for at-home COVID tests starting Saturday

Photo of four purple antigen COVID at-home tests sitting on a shelf

COVID-19 rapid at-home test kits rest on a table at a free distribution event for those who received vaccination shots or booster shots on Jan. 7 in Los Angeles. Photo: Mario Tama via Getty Images

Health insurers will be required to cover costs for over-the-counter, at-home COVID tests starting this Saturday, the Health and Human Services Department announced Monday.

Why it matters: Under President Biden's strategy to expand access to free COVID testing, insurers will either cover costs upfront or reimburse people after they submit claims.

  • But it’s unclear how the rollout will help the more immediate problem: millions are struggling to access tests due to a supply shortage.

How it works: Insurance companies will be required to cover eight tests per covered person per month, starting after Jan. 15. People will not need a doctor's order.

  • That means a family of four on the same plan would be able to access up to 32 tests per month for free.
  • There is no limit on the number of tests covered if they are ordered by a health care provider after a clinical assessment. This includes people who may need the tests due to underlying medical conditions.

Worth noting: Because people often have to wait an indefinite amount of time to get reimbursed, the Biden administration is pushing insurers and employers to set up programs that would give people direct access to tests with no out-of-pocket costs through pharmacies and retailers.

  • If an individual who has direct access through such programs purchases a test outside the network, insurers must reimburse them up to $12 per test.

Be smart: This does not include people on traditional Medicare or the uninsured.

  • But it does include Medicaid, and people with Medicare Advantage could also qualify depending on their plan.
  • The Biden administration is also providing up to 50 million free at-home tests to community health centers and Medicare-certified health clinics for distribution.
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