Everyone’s excited about covidtests.gov going online early, but there’s another piece of BIG news about at-home COVID-19 testing! The Biden Administration has directed health insurers to cover the cost of reasonable at-home COVID-19 testing in full.
As CNBC reports:
You’re now entitled to up to eight over-the-counter at-home tests per month, which must be fully reimbursed by your insurance company, with no deductibles or cost-sharing. Packages that include multiple tests will be considered a single test for the purpose of reimbursement.
Additionally, test kit costs are covered if they’re part of a clinical assessment by a health-care provider. That means you get eight free tests month, plus whatever number of tests a doctor asks you to take.
To be clear, that’s eight at-home tests per covered person per month.
For now, there are three major things to keep in mind:
- Check with your health insurer and ask if they have a preferred at-home test provider; some insurers apparently provide tests at no cost through preferred providers (e.g. “just pick them up at Wal-Mart at no cost with your insurance card”). If you buy your tests from a non-preferred provider, your insurer is only obligated to reimburse a maximum of $12 per test. Be sure to ask clearly, “What do I need to do to receive full reimbursement?”
- If you have to file a claim for reimbursement, you MUST have the receipt from your purchase.
- Make sure that you’re purchasing an approved at-home test. The FDA maintains lists of approved rapid antigen-based tests and approved molecular tests (aka PCR tests).
Some media reports suggest glitches in the initial rollout of this benefit, which I don’t consider particularly surprising; some reports have suggested keeping the boxes of your tests as additional “just in case” proof of purchase until you receive reimbursement.
As Kossack elwood dowd pointed out in the comments, this applies only to private insurers; for some reason, Medicare was not included in the American Rescue Plan legislation. In addition, it appears that Medicare Advantage plans are a hit-or-miss thing for this benefit. As HHS said in their announcement:
Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People enrolled in a Medicare Advantage plan should check with their plan to see if their plan offers coverage and payment for at-home over-the-counter COVID-19 tests.
If you have Medicare Advantage coverage, it’s worth your time to call your insurer and ask.
In any case, this is going to be Very Good Thing for folks with large families or persons in public-facing jobs. I’d call this another win for the Biden Administration.
Wednesday, Jan 19, 2022 · 2:49:26 PM +00:00
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wesmorgan1
United Healthcare policyholders can pick up tests with no out-of-pocket costs from Wal-Mart Pharmacy, Rite-Aid Pharmacy, and Bartell Drugs; you must present your UHC card. Purchases made elsewhere will only be reimbursed $12/test.