Insurance now covers at-home COVID testing kits – Leavenworth Times – Leavenworth Times

Kelly Tyko USA TODAY

Americans with health insurance can get up to eight at-home coronavirus tests for free because of a new requirement.

As of Saturday, private health plans will be required to cover over-the-counter tests at up to $12 per test. Consumers can either purchase the testing kits at no cost or submit receipts for reimbursement from the insurance company.

A family of five could be reimbursed for up to 40 tests per month. PCR tests and rapid tests ordered or administered by a health provider will continue to be fully covered by insurance with no limit.

“This is all part of our overall strategy to ramp up access to easy-to-use, at-home tests at no cost,” Health and Human Services Secretary Xavier Becerra said in a statement Monday. “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 Biden administration is trying to incentivize private insurers to cover the tests up-front and without a cumbersome reimbursement process.

Health insurance industry groups have said insurers would carry out the administration’s order but cautioned that consumers that it won’t be as easy as flipping a switch.

Health Care Service Corp., an independent licensee of the Blue Cross Blue Shield Association, said that if a member uses a pharmacy in its pharmacy benefit manager’s network, Prime, “they do not need to submit a separate claim for reimbursement.”

Aetna updated its website Friday with new frequently asked questions about the new requirement. The site said more information on how members can submit claims will soon be available.

• How do I get a free at-home COVID test with insurance?

According to the government’s frequently asked questions, starting Jan. 15, “most people with a health plan can go online, or to a pharmacy or store to purchase an at-home over-the-counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance.”

• How much is the COVID home test reimbursement?

Insurance companies are required to reimburse up to $12 per individual test or the cost of the test if it is less than $12. If the price of the test is more than $12 each, the consumer will have to pay the difference.

• Can I get reimbursed for past COVID test purchases?

Most likely, no. This will vary by insurance but plans and issuers are not required by federal law to “provide such coverage for at-home over-the-counter COVID-19 tests purchased before January 15,” the government FAQ said, suggesting consumers contact their health plans to ask about reimbursement for previous test purchases. Some states also already require coverage of the at-home tests.

• What about COVID tests at testing sites? Will they stay open?

Insurers are required to pay for coronavirus tests administered at testing sites and medical offices, which can cost $100 or more, based on previous legislation passed by Congress to address the pandemic. Home tests, which consumers can buy without a prescription at retail stores or online, are less expensive.

• How long will it take to receive test reimbursements?

“Health plans are encouraged to provide prompt reimbursement for claims for at-home tests, and consumers can find out directly from their plan how their claims process works and ask questions about reimbursement timing,” the government FAQ said.

• Will Medicare pay for home COVID tests?

Americans on Medicare won’t be able to get athome tests reimbursed through the federal insurance plan, but some Medicare Advantage Plans may cover and pay for over-the-counter coronavirus tests. The Medicare website says to check with your Advantage Plan to see if it will cover and pay for the tests.

• Will Medicaid and other government plans cover the tests?

As part of the American Rescue Plan, state Medicaid and Children’s Health Insurance Program programs are required to cover FDA-authorized at-home coronavirus tests. Coverage rules may vary by state, the federal government said.

• Can the uninsured get free tests? Those who are not on a covered insurance plan can

Those who are not on a covered insurance plan can receive free tests through the forthcoming federal website or from some local community centers and pharmacies.

Contributing: Associated Press