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Private health insurers will cover the cost of at-home COVID-19 tests starting Saturday


Starting Saturday, private health insurers will be required to cover up to eight at-home COVID-19 tests per month for people on their plans. The Biden administration announced the change Monday as it looks to lower costs and to make testing for the virus more convenient.

Under the new policy, Americans will be able to either purchase at-home testing kits for free under their insurance or submit receipts for the tests for reimbursement, up to the monthly per-person limit. A family of four, for example, could be reimbursed for up to 32 tests per month.

Roughly 150 million Americans, or about 45 percent of the population, are privately insured, mostly through their employers. Each enrolled dependent of the primary insurance holder counts as a member.

Anthony Desha with Flow's Pharmacy said he's told everyone if they can wait until Saturday to buy them, they should.

"They also only reimburse you $12 a test, so kind of just what I'm saying is each insurance company is different. I tell people just to make sure they check," Desha said.

At out-of-network facilities, insurers’ responsibility would be capped at $12 per test, meaning people could be responsible for any additional costs. But if a health plan does not establish “preferred” retailers where patients can get tests covered upfront, it will be responsible for whatever claims its patients submit for their eight monthly rapid tests, with no limit on the price.

Desha says, "It's different with every insurance but they're going to send you some paperwork then you'll have to fill out the paperwork either submitted via mail, fax or email, and then they should just send you a reimbursement check, or sometimes a Visa card."

Americans on Medicare won't be able to get tests reimbursed through the federal insurance plan, but Medicaid and Children’s Health Insurance Program plans are required to cover the cost of at-home tests fully.

Those who don't have health insurance can also access free kits at community health clinics and other local sites.

If an individual has been directed to undergo COVID testing by their medical provider, because of underlying health conditions or other factors, there is no limit on the number of tests covered.

Desha says the supply of at-home tests has been also been an issue. "It hasn't been consistent at all. It's been different. I think we've had four or five different brands. I just call as many wholesalers as I can and get as many as I can."

He also says there are some reasons why PCR testing locations aren't easily accessible.

"People shut everything down, you know, the testing sites and things because we thought we were nearing the end or out of it and now it's starting back up again, so everybody's wanting to get test or needing vaccines," Desha said.

For those without insurance, Biden said there will be "thousands of locations" where you can pick up free COVID-19 test kits to use at home in private, rather than get swabbed in a drive-thru clinic. A website will be made available early in 2022 where anyone can order free rapid antigen kits delivered to their home.

White House Press Secretary Jen Psaki promised that the Biden administration would start shipping out the 500 million free, at-home COVID-19 testing kits to Americans "early next week."

You may also want to check with your employer, as some private companies also began offering reimbursement options for at-home tests before the Jan. 15 deadline.

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Chanel Porter

Chanel joined ABC 17 News in January 2021 after graduating from Penn State University. She enjoys traveling and a daily iced coffee.


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