Are health insurance companies required to cover home COVID-19 tests?

Health Insurance Companies - COVID-19 home test

The Biden-Harris Administration announced that insurers and group plans must cover FDA-approved tests.

This week, the Biden-Harris Administration announced that health insurance companies and group plans will be required to cover FDA-approved home COVID-19 tests as of January 15.

As of January 15, policyholders will be able to obtain those home tests without out-of-pocket costs.

“This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost,” said Xavier Becerra, Secretary of the US Department of Health and Human Services (HHS). “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also purchasing half a billion at-home, rapid tests to send for free to Americans who need them. 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 HHS explained that insured Americans will be able to purchase the at-home tests covered by their health insurance companies in the commercial market without requiring a healthcare worker’s prescription, nor a clinical assessment. The purchase will be entirely covered by the policy or plan without any cost-sharing requirements such as co-payments, coinsurance or deductibles, and without needing medical management requirements such as prior authorization.

Health Insurance Companies - Pharmacy

Health insurance companies will cover FDA-approved tests sold online, or at a local pharmacy or store.

According to the new regulations, insurers must cover as many as 8 home COVID-19 tests per person, per month. As this regulation becomes effective on January 15, it does not apply to any of the tests purchased before that date. As a result, plan members and policyholders should not expect to receive a reimbursement for purchases made up to and including January 14. On January 15 and afterward, recommendations are that when purchases are made, receipts should be kept so that a reimbursement can be obtained through their insurer.

To understand the process precisely, it’s recommended that plan members and policyholders check with their health insurance companies. That will help to know how the reimbursement process will take place.

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.