1:42 PM PST, January 13, 2022
At-home test kits for COVID-19 are pricey and hard to come by in the country, but those who managed to secure can now get their money back. The White House announced Thursday that private health insurance companies are now required to cover the cost of over-the-counter COVID-19 diagnostic tests.
“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated,” Chiquita Brooks LaSure, Chief of Centers for Medicare & Medicaid Services, said in a statement. “Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people.”
The new requirement will take effect this coming Saturday.
Here’s what you need to know about the reimbursements:
How Many Test Kits Can I Be Reimbursed For?
Each person is now eligible to have the cost of eight at-home test kits reimbursed per month, meaning a family of four can have up to 32 tests covered per month even if they are all under the same healthcare plan.
For those who may have an underlying health condition or are otherwise ordered by a health care provider to receive more tests will not be limited in how many tests they can have reimbursed per month, according to the statement.
Will I Be Reimbursed the Full Amount For The Test?
It depends. If you ask your health plan’s preferred pharmacy or retailer for a COVID-19 at-home test, it will be provided to you with no out-of-pocket cost. In other words, the retailer would give you the test at no cost, then later be reimbursed directly by the insurance company.
If a test is not purchased at a preferred pharmacy or retailer, then you will have to file a claim to your health plan for the reimbursement. The insurance company is only responsible to reimburse up to $12.
If a health plan does not establish a preferred retailer, then the insurance company will be responsible for the entire cost, with no limit on the price.
Who Is Eligible?
At this point, only Americans who have private health care insurance are able to be reimbursed for at-home test kits under the latest ruling. There will be no co-pay or cost sharing requirement.
People who do not have health insurance or are covered by Medicare will not be able to seek reimbursement.
They are still, however, covered to receive COVID-19 testing at a healthcare facility, and the White House intends to send 50 million free, at-home tests to community health centers and Medicare-certified rural health clinics in order for them to distribute to their patients.
State Medicaid and Children’s Health Insurance Program (CHIP) programs already cover FDA-authorized at-home COVID-19 tests.
Which Tests Are Approved?
Every over-the-counter COVID-19 test authorized for emergency use by the U.S. Food and Drug Administration (FDA) is covered. Some examples include the following:
- Abbot’s BinaxNow
- Quidel’s QuickVue
- Orasure’s InteliSwab
- Intrivo’s On/Go
The FDA warned in November that there have also been fraudulent tests that have not been approved for emergency use, and consumers should be careful to avoid them as they will also not been covered under the plan.
I Purchased Tests Already. Are They Covered?
No, only tests purchased after January 15, 2022 can be reimbursed by their private insurance plans.
How Can I Get A Test?
Unfortunately, at-home test kits are still hard to come by in the U.S. and many major pharmacies continue to be out of stock.