The Biden administration announced this month that private health insurers will be required to cover up to eight home COVID-19 tests per month for people on their plans.
That means a family of four can get 32 tests per month for free.
Private insurers are only required to cover over-the-counter tests purchased on or after Jan. 15, 2022.
The tests will either be free directly at the point of sale (if your health plan provides for direct coverage), or by reimbursement if you are charged for your test.
At-home COVID-19 rapid test kits can be bought at stores like Walgreens, CVS and Walmart. Buyers can head to a pharmacy counter and present their health insurance card and ask them to bill their insurance.
If they end up being charged for a test, buyers can keep the receipt and submit a claim to their health plan for reimbursement.
Members can find out how to submit reimbursement claims directly from their plan. Here’s how members of some major health insurance companies in California can file a claim for over-the-counter tests:
- Blue Shield and Blue Shield Promise members who want to submit a claim for an at-home test kit can mail their receipt along with this claim form. Directions are available here.
- Oscar members have to visit Caremark.com, select “Plan & benefits” and then “Submit a prescription claim.” More instructions can be found here.
- Kaiser members can go to “Coverage & Costs” and select “Submit a medical claim.” The claim must include an itemized purchase receipt and the COVID-19 test’s QR or UPC code, cut out of the package. Details can be found here.
- Aetna members can submit a claim for reimbursement by logging in to their member website, clicking on “submit a claim for reimbursement” and following the claims submission instructions. More information can be found here.
- UnitedHealthcare members will need to submit a reimbursement form, including a receipt online at myuhc.com. Receipts can be submitted through a reimbursement form (pdf). Details can be found here.
Most companies will reimburse members either through direct deposit or a mailed check.
For those whose plans don’t have a network of preferred locations to buy tests from, they will be reimbursed the amount of the cost of the test.
For members who have plans that do have networks of preferred stores, pharmacies and online retailers where they can get a test with no out-of-pocket expense, they can still get tests from other retailers. But their plan is only required to reimburse them at a rate of up to $12 per test.
People on Medicare won’t be able to get at-home tests reimbursed through the plan. Medicare Advantage plans, however, may offer payment for over-the-counter COVID-19 tests, so members should check with their plan.
Recipients of Medi-Cal, California’s Medicaid program, and children covered by CHIP (Children’s Health Insurance Program) will be eligible for reimbursement.
While they’re not required by federal law to do so, some private U.S. insurance companies may choose to provide coverage for at-home over-the-counter COVID-19 tests bought before Jan. 15. Members can reach out to their providers to find out.
Tests authorized in the U.S. include Abbott BinaxNOW, Acon FlowFlex, Quidel Quickvue, Ellume and Pixel by LabCorp.
Here are full lists of the FDA’s antigen diagnostic tests and molecular diagnostic tests that have been authorized for home use.
More information on getting reimbursed can be found here.
