At-home COVID-19 tests will be covered by insurance companies Starting January 15, 2022

(WASHINGTON) – Starting Saturday, private health insurers will be required to pay for up to eight at-home COVID-19 tests per month for people on their plan. The Biden administration announced the change Monday because it appeared to reduce costs and make testing for the virus more convenient amid growing frustration.

Under the new policy, detailed for the first time by AP, Americans will be able to purchase free home testing kits under their insurance or submit a test receipt for reimbursement, up to monthly limit per person. For example, a family of four can be reimbursed for up to 32 tests per month. PCR tests and rapid tests ordered or performed by a healthcare provider will continue to be covered with absolutely no limits.
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President Joe Biden has faced criticism over the holiday for a shortage of rapid tests at home as Americans visit family amid a surge in cases from the more transmissible omicron variant. Now the administration is working to make COVID-19 home testing more accessible, by increasing supply and reducing costs.

Read more: Why, When and How to test for COVID-19 at home

Later this month, the federal government will launch a website to begin delivering 500 million COVID-19 home tests by mail. The authorities are also expanding emergency rapid testing sites in areas with the sharpest increase in cases.

Insurer-paid testing will significantly reduce costs for many Americans, and the administration hopes that by loosening the barrier to more frequent home testing, it could help slow the spread of the virus. spread of the virus, get kids back to school faster, and help people assemble safely.

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

Biden announced the federal request late last year and it went into effect January 15, but the administration has been quiet so far about the details of the plan.

The government is trying to encourage private insurers to cover exams in advance and without a cumbersome reimbursement process. Insurance plans that work with pharmacies and retailers to pay for the upfront costs of tests will only be required to reimburse up to $12 per test if purchased through a out-of-network retailers. Plans that don’t actively establish a network of pharmacies will have to cover the full retail price paid by the customer – possibly more than $12 per check.

Two main health insurance industry groups say insurers will follow the government’s orders, but warn consumers it won’t be as easy as flipping a switch.

Read more: Biden’s plan for ‘free’ COVID tests at home isn’t as simple as it sounds

“Health insurance providers will work as quickly as possible to implement this guidance in ways that limit consumer confusion and challenge,” said Matt Eyles, president of Health Insurance Planning of the United States, said in a statement. “While there may be some hiccups in the early days, we will work with the authorities to quickly resolve issues as they arise.”

The Blue Cross Blue Shield Association had a more direct response. “We are concerned that this policy does not address the limited supply of testing in the country and could cause additional friction for consumers as insurers offer plans in just four days. ,” Kim Keck, the group’s president, said in a statement. .

Both groups said they support provisions of the Biden administration’s plan to combat potential price manipulation in the tests.

Only tests purchased on or after January 15 will be required to be refunded, the authority said. Some insurance companies may choose to cover the cost of a pre-purchased home test, but they won’t have to.

Mina Bressler, a mother of two and a therapist in San Mateo, California, was able to purchase quick test kits online and share some of them with a parent who works in the translation industry. service and didn’t have time to “sit at her computer for hours refreshing the Walmart page to see when tests were available. ”

“I gave her some and her children went to school. It was one time and there was a million of her,” said Bressler.

“Just as the vaccine becoming available really shines a light on the unfairness of what is happening during this pandemic, I think testing is the new flashlight for that because who is online following Walmart ? It’s not the most vulnerable people in the county,” Bressler added.

Americans on Medicare will not be able to get reimbursement for tests through federal insurance, but Medicaid and the Children’s Health Insurance Programs are required to cover the full cost of the tests. experience at home. Those not on a covered plan can get free tests through the federal upcoming website or from some community centers and local pharmacies.


Phoenix-based AP writer Terry Tang contributed.

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