President Joe Biden announced this week
that private insurers will have to cover at-home COVID tests. But several major health insurers say that they are still working out the kinks and details of how tests will be covered, along with the deadline to implement the plan with only days away.
At-home tests for COVID-19 tests can provide a convenient alternative to waiting in line in the cold. This is a great way for people who have to go to work or school; usually, these tests cost around $24 for a two-pack and the costs can add up.
Starting January 15th, every person with private insurance can receive up to eight FREE at-home COVID tests a month. That means a family of four will be entitled to 32 tests — that's worth around $384 at retail. But how will coverage work? And how easy it will be to take advantage of the home testing benefits will depend on each person's health plan.
The administration has not standardized how this process will work and how you will get reimbursed or a timeline for how to receive the reimbursements. A lot of it is going to vary from plan to plan and just depends on the insurance you have.
Some people may have to pay for the tests upfront and seek to get reimbursed by their health plan which will also include some leg work. People should definitely hang onto those receipts.
Biden is pushing for health insurers to partner up with pharmacies so that members can bring their tests to the counter, show their insurance card, and take them home without having to pay anything upfront. This would work similarly to picking up a script.
The catch is that the plans could require members to go to a preferred or in-network pharmacy. If a member buys their test from an out-of-plan network, they can reach out to their insurance provider to get reimbursed up to $12 per individual test.
However, not all pharmacies are regularly stocked with tests and this could pose a challenge. Some have raised concerns about whether the at-home testing companies that have FDA authorization for their products are producing enough tests to support Biden's plan. The president is also seeking to make 500 million home test kits available for all Americans to order online via a government website that will be set up later this month. It's unclear how many each household will be able to receive.
Meanwhile, Biden's insurance mandate does not apply to those on public insurance. New Yorkers that are covered by Medicaid are able to access up to EIGHT free tests a month for free — but only if ordered by a Medicaid-covered healthcare provider, similar to getting a prescription, people with private insurance won't have to deal with that hurdle under Biden's plan.
Nearly half of New Yorkers are insured through Medicaid, a public plan for people with low incomes, and those people are likely the ones who will benefit the most from having home testing costs waived.
