Starting Saturday, private health plans are required to cover the over-the-counter tests at up to $12 per test. Consumers can either purchase the testing kits at no cost or submit receipts for reimbursement from the insurance company.
A family of five could be reimbursed for up to 40 tests per month under the plan. PCR tests and rapid tests ordered or administered by a health provider will continue to be fully covered by insurance with no limit.
President Joe Biden announced the federal requirement for insurance companies in December and officials said Monday that it would begin Jan. 15.
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“This is all part of our overall strategy to ramp up access to easy-to-use, at-home tests at no cost,” Health and Human Services Secretary Xavier Becerra said in a statement Monday. “By requiring private health plans to cover people’s at-home tests, we are further expanding Americans’ ability to get tests for free when they need them.”
The administration is trying to incentivize private insurers to cover the tests up-front and without a cumbersome reimbursement process.
Health insurance industry groups have said insurers would carry out the administration’s order, but cautioned consumers that it won’t be as easy as flipping a switch.
Health Care Service Corporation or HCSC, an independent licensee of the Blue Cross Blue Shield Association, told USA TODAY that if a member uses a pharmacy in its pharmacy benefit manager’s network, Prime, “they do not need to submit a separate claim for reimbursement.”
Aetna updated its website Friday with new frequently asked questions about the new requirement. The site said more information on how members can submit claims will soon be available.
Biden free COVID tests plan
The Biden administration will launch a website where Americans can order free COVID-19 tests Wednesday, Jan. 19.
The tests, part of the administration’s purchase of 500 million tests last month to help tackle a record surge in infections, will be mailed to homes within seven to 12 days, according to an official who briefed reporters.
Biden announced earlier this week the administration would double its order with the purchase of an additional 500 million at-home COVID-19 tests amid a shortage of tests nationwide that’s led to long lines at testing locations and overburdened hospitals.
How do I get a free at-home COVID-19 test with insurance?
According to the government’s frequently asked questions, starting Jan. 15, “most people with a health plan can go online, or to a pharmacy or store to purchase an at-home over-the-counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance.”
How much is the COVID home test reimbursement?
Insurance companies are required to reimburse up to $12 per individual test or the cost of the test if it is less than $12. If the price of the test is more than $12 each, the consumer will have to pay the difference.
Can I get reimbursed for past COVID test purchases?
Most likely, no. This will vary by insurance but plans and issuers are not required by federal law to “provide such coverage for at-home over-the-counter COVID-19 tests purchased before January 15,” the government FAQ said, suggesting consumers contact their health plans to ask about reimbursement for previous test purchases. Some states also already require coverage of the at-home tests.
What about COVID tests at testing sites? Will they stay open?
Insurers are required to pay for coronavirus tests administered at testing sites and medical offices, which can cost $100 or more, based on previous legislation passed by Congress to address the pandemic. Home tests, which consumers can buy without a prescription at retail stores or online, are less expensive.
How long will it take to receive test reimbursements?
“Health plans are encouraged to provide prompt reimbursement for claims for at-home tests, and consumers can find out directly from their plan how their claims process works and ask questions about reimbursement timing,” the government FAQ said.
Will Medicare pay for home COVID tests?
Americans on Medicare won’t be able to get at-home tests reimbursed through the federal insurance plan, but some Medicare Advantage Plans may cover and pay for over-the-counter COVID-19 tests. The Medicare website says to check with your Advantage Plan to see if it will cover and pay for the tests.
Will Medicaid and other government plans cover the tests?
As part of the American Rescue Plan, state Medicaid and Children’s Health Insurance Program (CHIP) programs are required to cover FDA-authorized at-home COVID-19 tests. Coverage rules may vary by state, the federal government said.
Can the uninsured get free tests?
Those who are not on a covered insurance plan can receive free tests through the forthcoming federal website or from some local community centers and pharmacies.
How can I order free COVID tests from the government?
“Every home in the U.S. can soon order 4 free at-home COVID-19 tests. The tests will be completely free – there are no shipping costs and you don’t need to enter a credit card number,” according to a message on the government website.
What is the website to order free COVID tests?
The website for ordering free COVID tests is Covidtests.gov.
Contributing: Associated Press; Courtney Subramanian, Maureen Groppe and Ken Alltucker, USA TODAY