July 3, 2022
  • July 3, 2022

COVID-19 home tests will be covered by health insurance

By on January 10, 2022 0

From Saturday, private health insurers will be required to cover up to eight at-home COVID-19 tests per month for people on their plans. The Biden administration announced the change on Monday as it seeks to cut costs and make testing for the virus more convenient amid growing frustrations.

Under the new policy, first detailed at the AP, Americans will be able to either purchase free home testing kits as part of their insurance or submit receipts for the tests for reimbursement, until the monthly limit per person. A family of four, for example, could be reimbursed for up to 32 tests per month. PCR tests and rapid tests ordered or administered by a health care provider will continue to be fully covered by No Limit Insurance.

President Joe Biden has come under fire over the holiday season for a shortage of rapid home tests as Americans travel to see family amid soaring cases of the more transmissible omicron variant. Now the administration is working to make home COVID-19 testing more accessible, both by increasing supply and reducing costs.

Later this month, the federal government will launch a website to begin making 500 million home COVID-19 tests available by mail. The administration is also expanding emergency rapid testing sites in areas seeing the highest increases in cases.

Insurer-covered testing would significantly reduce costs for many Americans, and the administration hopes that removing a barrier to more regular home testing can help slow the spread of the virus, bring children back to school faster and helping people. gather safely.

“This is all part of our overall strategy to accelerate access to easy-to-use, no-cost home testing,” Health and Human Services Secretary Xavier Becerra said in a statement. “By requiring private health plans to cover people’s home testing, we are further expanding the ability of Americans to get free testing when they need it.”

Biden announced the federal requirement late last year, and it will go into effect Jan. 15, but the administration had remained silent until now on details of the plan.

The administration is trying to entice private insurers to cover testing up front and without a cumbersome reimbursement process. Insurance plans that work with pharmacies and retailers to cover the upfront costs of tests will only be required to reimburse up to $12 per test if purchased from an out-of-network retailer. Plans that don’t proactively move to set up a pharmacy network would need to cover the full retail price paid by the customer — which could be more than $12 per test.

A major health insurance industry group said insurers would carry out the administration’s order, but warned consumers it would not be as simple as flipping a switch.

“Health insurance providers will work as quickly as possible to implement these guidelines in a way that limits consumer confusion and challenges,” Matt Eyles, president of U.S. Health Insurance Plans, said in a statement. “While there will likely be a few hiccups in the early days, we will work with administration to quickly resolve issues as they arise.”

The group said it supports the provisions of the Biden administration’s plan to counter potential price hikes on testing.

Only tests purchased on or after January 15 will need to be reimbursed, the administration said. Some insurers may choose to cover the costs of home tests purchased earlier, but they won’t have to.

Mina Bressler, a mother of two and therapist in San Mateo, Calif., was able to purchase rapid test kits online and shared some with a parent who works in the service industry and doesn’t have time to “s ‘sit in front of your computer every hour’. refresh the Walmart page to see when the tests are in stock.

“I gave it to him and his children went to school. It’s once and there’s a million,” Bressler said.

“Just as the vaccines that are becoming available have really brought to light the inequity of what is happening in this pandemic, I think testing is the new flashlight for this because who is going to hunt down Walmart online? They are not the most vulnerable people in the county,” Bressler added.

Americans on Medicare will not be able to be reimbursed for testing by the federal insurance plan, but Medicaid and Children’s Medicare plans are required to fully cover the cost of home testing. Those not covered by an insurance plan can receive free tests through the future federal website or from some local community centers and pharmacies.