WASHINGTON (AP) – Starting Saturday, private health insurers will be required to cover eight home COVID-19 tests per month for people on their plans. The Biden administration announced the changes on Monday as it looks to reduce costs and make testing for the virus more convenient amid growing frustrations.
Under the new policy, first detailed to the AP, Americans will be able to either purchase home testing kits for free under their insurance or submit receipts for tests for reimbursement up to the monthly limit per person. For example, a family of four can be reimbursed for up to 32 tests per month. PCR tests and rapid tests ordered or administered by a health provider will continue to be fully covered by insurance, without limitation.
President Joe Biden has faced criticism for a lack of rapid at-home tests during the holiday season as Americans travel to see family amid a surge in cases of the more transmissible Omicron variant. Now the administration is working to make COVID-19 home tests more accessible, by increasing supplies and reducing costs.
Later this month, the federal government will launch a website to make 500 million at-home COVID-19 tests available via mail. The administration is also ramping up emergency rapid-testing sites in areas experiencing the biggest surge in cases.
Insurer-covered testing would dramatically reduce costs for many Americans, and the administration hopes that by lowering a barrier to more routine testing at home, it could help slow the spread of the virus, Can get kids back to school more quickly and help people. assemble safely.
“This is part of our overall strategy to increase access to easy-to-use, at-home tests at no cost,” Health and Human Services Secretary Javier Becerra said in a statement. “By requiring private health plans to cover people’s at-home tests, we are expanding the ability for Americans to get tested for free when they need it.”
Biden announced the federal requirement late last year, and it began on January 15, but the administration had remained silent on the details of the plan until now.
The administration is trying to encourage private insurers to cover the trials without any cumbersome reimbursement process. Insurance plans that work with pharmacies and retailers to cover the upfront cost of the test will require reimbursement of only $12 per test if purchased through an out-of-network retailer. Plans that do not actively move to establish a network of pharmacies must cover the full retail price paid by the customer – which can exceed $12 per test.
There was no immediate response from insurers, or potential insurer and retailer involvement, before the effective date of Saturday.
Only tests purchased on or after January 15 would need to be reimbursed, the administration said. Some insurers may choose to cover the costs of previously purchased home tests, but they do not have to.
Mina Bresler, a mother of two and a physician in San Mateo, Calif., was able to purchase rapid test kits online and share some with a parent who works in the service industry and has “every hour of her life.” Don’t have time to sit at the computer “Refresh the Walmart page to see when tests are in stock.”
“I gave him something and his kids went to school. That’s once and he has a million,” Bressler said.
“Just as having vaccines available highlights the disparity of what is actually happening in this pandemic, I think testing is the new flashlight for that because who is following Walmart online? It is not the most vulnerable people in the county,” Bressler said.
Americans on Medicare will not be able to receive tests reimbursed through a federal insurance plan, but plans for Medicaid and the Children’s Health Insurance Program are required to fully cover the cost of home tests. People who are not on a covered insurance plan can get a free trial through the upcoming federal website or through some local community centers and pharmacies.