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

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

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

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

Americans with health insurance won’t need a prescription from a health care provider, nor will they need to rely on “cost-sharing requirements such as deductibles, co -payments or coinsurance, prior authorization or other medical management requirements,” according to a Health and Human Services Department release.

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

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

The administration “strongly urges” insurers and health plans to allow people to get tested at home through “preferred pharmacies, retailers or other entities without outlay,” a White House statement said on the plan. The incentive for insurers is that if they do not implement such a “preferred” system of COVID test retailers, then the insurance company will have to reimburse the full price of the test.

So, for example, if an insured purchases a box of two tests that costs $34 and the insurer does not have a preferred system in place, the insurer will reimburse the full amount of $34.

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

The White House also said it was launching a website where Americans will be able to request free rapid tests to be delivered to their homes, but the website has not yet launched. 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