COVID home tests: Insurance companies to start reimbursing Americans on Saturday for up to 8 tests per month

Americans with private insurance will be able to claim reimbursement for rapid COVID-19 tests starting Saturday – but any test purchased before January 15 will not be eligible.

The Biden administration’s requirement allows eight tests per month per person covered by the insurance policy. For example, a two-person household covered by a private health insurance plan could claim reimbursement for 16 tests per month.

The new requirement will cover any over-the-counter COVID-19 test that has received emergency use authorization from the United States Food and Drug Administration. This list includes Abbott BinaxNOW Home Tests, iHealth COVID-19 Antigen Rapid Test, Siemens Healthineers COVID-19 Rapid Self-Test and COVID-19 Flowflex Antigen Home Tests, among dozens of others. (See here for the full list, which continues to grow.)

Americans with health insurance will not need a prescription from a health care provider, nor will they need to rely on “cost-sharing requirements such as deductibles, quotes.” -parts or coinsurance, prior authorization or other medical management requirements, ”according to a health organization. and the release of the Department of Social Services.

Individuals will likely need to log into their health insurance company’s websites to file a claim.

The new requirement is one of the steps the Biden administration has taken to make rapid testing more accessible, although critics of the plan say the administration should make testing free at the point of purchase and should offer a retroactive refund. . But Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, maintained that reimbursement would still help. “Today’s action further removes financial barriers and extends access to COVID-19 testing to millions of people. ”

The administration is “strongly urging” insurers and health plans to allow people to take tests at home through “preferred pharmacies, retailers or other entities at no additional cost,” a White House statement said on the plan. The incentive for insurers is that if they don’t put in place such a “preferred” retailer system of COVID testing, the insurance company will have to reimburse the full cost of the test.

So, for example, if an insured buys a box with two tests that costs $ 34, and the insurer has not set up a preferential system, the insurer will reimburse the full amount of $ 34.

But if there is a preferred network set up, if a person purchases tests outside the network, insurers would only be required to reimburse “at a rate of up to $ 12 per individual test.” Most of the at-home tests available come with two per box and tend to cost just over $ 20.

The White House has also stated that it launch of a website where Americans will be able to request free rapid tests to be delivered to their homes, but the website has yet to launch. The White House is finalizing contracts with companies, including Revival Health Inc. and Goldbelt Security, LLC, to assemble the tests.

Bo Erickson contributed to this article.

Kristan F. Talley