By Nathalie Voit
The Biden-Harris administration announced it will now require private insurance companies and group health plans to cover the costs of up to eight at-home over-the-counter COVID-19 tests per month beginning Jan. 15, the U.S. Department of Health and Human Services said in a press release.
The new policy is part of the administration’s plan to expand Americans’ access to free testing and limit the spread of Omicron.
Covered individuals will either get their test paid upfront directly by their health plan or be reimbursed for the test pending submission of a claim.
According to the new mandate, individuals with private coverage will be able to obtain the tests without any cost-sharing burden such as deductibles, coinsurance, co-payments, or prior authorization. A family of four under the same plan, for example, would be able to get up to 32 tests covered by their insurance per month.
Additionally, individuals who are required to get a test by their health care providers for medical reasons will have no limit on the number of covered tests.
“This is all part of our overall strategy to ramp up access to easy-to-use, at-home tests at no cost,” said HHS Secretary Xavier Becerra.
“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.”
As part of the new policy, the White House encourages insurers to set up programs with preferred pharmacies or retailers so that tests are covered upfront with no out-of-pocket cost to the consumer. However, individuals who choose to purchase a test outside of their plan’s preferred network will still be reimbursed by their insurance up to $12 per test.
The news comes as the price of many at-home COVID-19 test kits has increased, driven by soaring demand due to the rapid spread of the highly contagious Omicron variant.
While many kits recently sold for $12 a box, cheaper tests have become harder to find as federal subsidies that kept over-the-counter kits affordable came to an abrupt end in mid-December.
The scarce supply of COVID-19 testing kits has also pushed prices up, leading many retailers like Amazon and Walmart to limit the number of tests each customer can buy.
“Health insurance providers will work as quickly as possible to implement this guidance in ways that limit consumer confusion and challenges,” said Matt Eyles, president of America’s Health Insurance Plans, one of the nation’s two main health insurance industry groups, in a statement in response to the announcement.
“While there will likely be some hiccups in early days, we will work with the administration to swiftly address issues as they arise.”
