Milwaukee Journal Sentinel

Insurance now covers at-home COVID testing

- Kelly Tyko Contributi­ng: Associated Press

Americans with health insurance can get up to eight at-home coronaviru­s tests for free because of a new requiremen­t.

As of Saturday, private health plans will be required to cover over-thecounter 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.

“This is all part of our overall strategy to ramp up access to easy-to-use, athome 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.”

Health insurance industry groups have said insurers would carry out the administra­tion’s order but cautioned that consumers that it won’t be as easy as flipping a switch.

Aetna updated its website Friday with new frequently asked questions about the new requiremen­t.

How do I get a free at-home COVID 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 difference.

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 offices, 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 find 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 coronaviru­s tests. The Medicare website says to check with your Advantage Plan to see if it will cover 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 programs are required to cover FDA-authorized at-home coronaviru­s 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 federal website or from some local community centers and pharmacies.

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