As of January 15, private insurance companies are required to reimburse members for at-home COVID-19 test purchases.
This private insurance reimbursement program differs from the White House Program that offers free COVID-19 tests through the Federal Government, delivered by the United States Postal Service.
This new program requires private insurance companies to cover up to 8 at-home tests per member, per month. It covers only at-home COVID-19 tests that are purchased on or after January 15.
This major shift has led to a lot of inquiries, as well as confusion among consumers.
With limited information currently available from most insurance companies, we want to provide a detailed overview on how you can obtain your reimbursement for rapid, at-home COVID-19 tests, as well as the general requirements and guidelines involved in this new insurance reimbursement program.
In this article, we explain:
This requirement covers any COVID test that is authorized by the FDA, and tests available over the counter (OTC), including Lucira Check It. Only at-home COVID tests purchased on or after January 15, 2022, are eligible for reimbursement.
The program covers 8 free tests per individual, per month. The White House confirmed that this means that “a family of four, all on the same plan would be able to get 32 tests covered by their health plan per month.”
If an employer buys tests for employees to test for work, these are excluded.
Those covered by Medicare are NOT currently eligible to get reimbursed for at-home COVID-19 tests.
Medicaid and Children’s Health Insurance Program (CHIP) plans are required to cover the costs of at-home tests.
Short answer: it depends on your insurance plan. Because every private insurance company is required to reimburse members for their purchases, your plan’s website should have an informational COVID-19 page on their site that will give you instructions on how to obtain reimbursement.
Some insurers, like Kaiser Permanente, Aetna, and Blue Shield of California, are asking policyholders to request reimbursement after purchasing tests. Others may cover the costs upfront when you buy the test by simply showing your member ID. For example, UnitedHealthcare is partnering with a limited number of test providers, including Rite Aid and Walmart Pharmacy to allow their members to pick up tests for free directly from select pharmacies.
Because every insurance plan is different, it is important to understand your plan’s requirements for reimbursement before your purchase your tests.
Private insurance providers are required to either fully reimburse tests you have purchased or provide information on where their members can go to get free tests. If your insurance provider has given you a place to go for free tests, they must still reimburse tests you bought elsewhere, but they may cap that reimbursement at $12 per test. (Source: KQED)
Be sure to double-check with your insurance provider for their specific requirements. For most, you need a receipt with how much you paid, along with some information on the at-home COVID-19 test you purchased, most of which should be on your receipt.
Every plan is different. Even if getting your reimbursement is slow, know that, by law, you will be reimbursed eventually.
Keep in mind that private insurance is required to reimburse members. Some insurance companies are launching programs that may cap reimbursements, but those that do not launch this type of program must reimburse your at-home COVID test in full. Even if your insurance implements a partial reimbursement program, they must still cover tests in full that were purchased prior to the launch of the program, so don’t delay.
If you do not have health insurance, you can order four free at-home COVID tests online through the USPS, provided by the federal government. Learn more about the program for free at-home COVID tests by reading the White House Brief.
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