How to get your free home COVID test covered by insurance

Most Americans with health insurance will be able to access free COVID-19 tests from Saturday, but insurers are not required to reimburse those who purchased the kits before.

Last month, President Joe Biden announced the measure as part of a plan aimed at curbing the pandemic. It also included the distribution of 500 million at-home COVID-19 tests to be sent in January, although no further details are yet available.

On Monday, the Department of Health and Human Services (HHS) said that people covered by a health insurance plan who purchase a federally-approved over-the-country COVID-19 diagnostic test will be covered by their insurers starting January 15. cost will be met.

The Biden administration is encouraging insurers and group health plans to establish programs where people can receive tests directly through preferred pharmacies, retailers or other entities at no out-of-pocket costs.

This would allow insurers and plans to cover the cost upfront, meaning consumers would not have to submit a claim for reimbursement.

“This is part of our overall strategy to increase access to easy-to-use, home tests at no cost,” HHS Secretary Javier Becerra said in Monday’s statement.

Here are some other details of the scheme:

Who is eligible and how can you get a free COVID-19 test?

As of Saturday, the majority of the estimated 150 million Americans who are privately insured – mostly through their employers – can go online, to a pharmacy or store, to stay at home authorized by the US Food and Drug Administration to prevent COVID-19. 19 Get a diagnostic test done. FDA).

HHS announced on Monday that the Biden administration is “strongly encouraging” health plans and insurers to set up a network of places such as pharmacies or retailers where people can order online or over the counter at home to prevent COVID-fighting. Can take 19. Free trial.

The test will either be free at the point of sale, if your health plan provides direct coverage, or by reimbursement if you are charged. People are asked to check with their plan or insurer to find out which option is possible.

Consumers who have to pay for the kit are asked to keep their receipt for submitting any claim for reimbursement, the deadline for payment of which will depend on the provider.

Those whose plan does not provide a network of locations where free trials are available may be reimbursed the full cost of the trial.

However, consumers who receive tests outside their network of providers’ preferred locations will cost the test a reimbursement rate of $12 per test or less.

Can I get reimbursed if I have already purchased a kit?

The plan announced by the Biden administration only compels health insurers and plans to provide tests purchased on or after January 15, 2022.

HHS said plans or issuers “are not required, but are not required by federal law, to provide such coverage for over-the-counter COVID-19 tests at home purchased before January 15th.” “

HHS said people should contact their providers to see if they can get reimbursed for kits they purchased before this date, adding that in some states “at home, over-the-counter There may be existing requirements relating to the coverage of COVID-19 tests.”

Insurance companies and health plans are required to cover eight free over-the-counter, at-home tests per covered person per month. This means that a family of four people on the same plan will be able to receive 32 of these tests per month.

What if I am not insured or on Medicare?

HHS said up to 50 million free, at-home tests would be provided to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members.

It also reiterated the Biden administration’s plan to buy 500 million at-home tests for free starting this month, but doesn’t know much about ordering them online.

“More information about this federal program is expected soon,” HHS said.

Medicaid and the Children’s Health Insurance Program (CHIP) already cover at-home testing with no cost-sharing.

Medicare covers COVID-19 testing in a laboratory when ordered by a medical professional, although “Original Medicare cannot pay for at-home testing at this time.”

HHS said people enrolled in Medicare Advantage plans should check with their insurers to see whether at-home testing will be paid for.

A medical worker performs a COVID-19 test at the Times Square subway station on December 27, 2021 in New York City. Americans can claim free testing kits from their health insurers starting January 15, 2022.
Scott Haynes / Getty