January 15 marks the first day That private health insurers must reimburse policyholders for at-home COVID-19 tests they purchase, according to guidelines the Biden administration published Monday.
However, insurance companies may not have their systems operational by then to comply with the new guidelines, which were originally announced in early December but were only recently finalized.
The directive requires private insurers to cover eight rapid COVID-19 tests per month by either setting up a network of retailers so that policyholders do not have to pay upfront for tests, or allowing consumers to submit receipts for reimbursement.
If the policyholder purchases a test from an out-of-network vendor, insurers are only required to pay up to $12 per test.
— they were unable to provide details on how consumers could be reimbursed for tests from January 15.
“Access to testing has been a critical part of our pandemic response. We are reviewing the guidelines and plan to adjust our coverage policies as needed,” Ethan Slavin, an Aetna spokesperson, told MarketWatch.
“We are reviewing the Biden administration’s recent guidance on reimbursement for at-home COVID-19 tests,” said Marc Brown, a spokesperson for KaiserPermanente. “We are working to make these tests available to our members for free through multiple outlets.”
UnitedHealth declined to comment. Cigna and Anthem have not responded to requests for comment.
“Plans and insurers are working quickly to determine how they will cover or reimburse over-the-counter COVID-19 tests, and may not be able to answer questions until after Jan. 15.eA spokeswoman for the Centers for Medicare & Medicaid Services told MarketWatch.
“If a consumer has to pay for a test, the person must keep their receipt and file a claim with their health plan for reimbursement,” the spokeswoman added. “Consumers can see directly from their plans how they are submitting a reimbursement request. Plans should not design their refund process in such a way as to unnecessarily delay the refund to a consumer.”
If you are covered by Medicaid or Children’s Health Insurance Program (CHIP) programs, you are entitled to at-home COVID testing with no cost sharing.
But if you’re not insured or covered by Medicare, you can get free tests through an upcoming federal website or from some local community centers and pharmacies.