Insurance is denying COVID test kit claims, using language that mismatched federal guidelines?
I'm having a really rough time over the past year getting COVID test kits reimbursed through my insurance. February it has come to a breaking point for me.
Beginning of January I got 5 kits and they got covered. But end of January I wanted to order for February, didn't realize it was the 31st still, so they refused reimbursing all of them. But they reimbursed 3, which 3+5=8
February 28th comes and I have 0 kits claimed at that point for the month of February. I order 8 kits. They only reimbursed 1 of 8. The reason I'm told is because "there is a 30 day delay between COVID kits". that makes zero sense to me since why did 1 kit get reimbursed?
So I call back again and again, different people give me different reasons. Like "oh it's the negotiated rate". I try to explain it isn't, that's not how COVID tests work per not only the federal mandate (https://www.cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free) but ALSO the gosh darn insurance website specifically says multiple times in multiple places "per month". The only mention of 30 days is:
"Your plan may limit the number of tests reimbursed to no less than eight OTC COVID-19 tests per covered individual per 30-day period (or per calendar month)."
28th is not above 30 days of the 31st, but the calendar months I'm owed 8 kits. This makes no sense even if I use their rule, because in 30 days I only got reimbursed for 4 kits. And if this is true, then why did my previous reimbursements not also have this rule?
What do I do? This seems federally wrong to me and they're not helping, it's a new run around every time.
submitted by /u/TeaLucky5396
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