Insurance Companies Must Cover COVID-19 At-Home Test Kits
This week, the Biden-Harris Administration announced plans to increase access to COVID-19 testing by requiring private health insurance companies to cover eight free at-home COVID test kits per insured person each month. A prescrition is not required to get reimbursed. This applies to testing kits purchased on or after Saturday, January 15, 2022. Insurers may reimburse for at-home tests purchased before this effective date, but they are not required to do so under the new guidance. The Administration also plans to buy a half-billion at-home COVID test kits and mail them to people who want them using the United States Postal Service, with deliveries set to begin this month.
Medicaid and the Children's Health Insurance Program (CHIP) already must cover FDA-authorized at-home COVID tests for free. Medicare beneficiaries can get COVID testing, including PCR and antigen tests, at a lab for free if the test is ordered by a health care professional. At this time, people on Medicare will not be able to get at-home COVID tests reimbursed through their health insurance.
To get a covered test, you can either purchase it at a pharmacy or other retailer and it will be free if your insurance plan provides for direct coverage, or you can get reimbursed for the test(s) after you buy them. Be sure to keep receipts. You will need them to submit a claim for reimbursement to your insurance company.
If your health plan has set up a network of preferred providers at which you can get a free test, you can still get tests from other retailers outside that network. Insurance companies will reimburse you up to $12 per test (or the cost of the test, if less than $12).
If you can’t afford to purchase the test kits out of pocket and then get reimbursed later, or if you are uninsured, there will be a website where you can request at-home test kits to be delivered to your home for free. More information on this federal program is expected soon. People without insurance can also get free at-home tests from some community health centers. To locate a community health center in Pennsylvania, use the Pennsylvania Association of Community Health Centers’ search tool here.
Tests ordered by a physician, non-physican practioner, or other authorized health care professional, including at-home and PCR tests, will still be fully covered by health insurance with no limit.
For more information about how to get your free at-home COVID-19 test kits, see this Frequently Asked Questions document prepared by the Centers for Medicare & Medicaid Services (CMS).
