U.S. Private Health Insurers Now Required to Cover at-Home COVID Tests

Private health insurers in the United States will be required to cover as many as eight at-home COVID tests per month for their customers starting Saturday.

Those on private insurance plans will be allowed to buy the tests for free using their insurance, or submit a receipt to their insurer to be reimbursed for up to eight tests per month, with insurers given the choice if they want to reimburse for tests purchased before Saturday, according to a description of the policy given to the Associated Press.

The policy comes as the Biden administration has looked for ways to make COVID tests more accessible for millions of Americans and lower the cost for the tests to be bought through stores.

The administration reportedly hopes increased testing will allow people to feel more comfortable about sending kids to school, going to work and returning more to normal activities as people who can know for a fact they are or are not infected and potentially contagious.

"This is all part of our overall strategy to ramp up access to easy-to-use, at-home tests at no cost," Health and Human Services Secretary Xavier Becerra said in a statement, according to the AP. "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."

At Home COVID Tests, Private Health Insurance
Employees of the Miami-Dade Public Library System distribute COVID-19 home rapid test kits in Miami, Florida last Saturday. Private health insurers will be required to cover the purchase of up to eight at-home COVID tests for their customers starting this Saturday, the Biden administration announced Monday. Chandan Khanna/AFP via Getty Images

A family of four, for instance, could be reimbursed for up to 32 tests per month. PCR tests and rapid tests ordered or administered by a health provider will continue to be fully covered by insurance with no limit.

President Joe Biden faced criticism over the holiday season for a shortage of at-home rapid tests as Americans traveled to see family amid the surge in cases from the more transmissible Omicron variant. Now the administration is working to make COVID-19 home tests more accessible, both by increasing supply and bringing down costs.

Later this month, the federal government will launch a website to begin making 500 million at-home COVID-19 tests available via mail. The administration also is scaling up emergency rapid-testing sites in areas experiencing the greatest surges in cases.

Biden announced the federal requirement late last year, and it kicks in on January 15, but the administration had been silent until now on details of the plan.

The administration is trying to incentivize private insurers to cover the tests up-front and without a cumbersome reimbursement process. Insurance plans that work with pharmacies and retailers to cover the up-front costs of the tests will be required to reimburse only up to $12 per test if purchased through an out-of-network retailer. Plans that don't move proactively to set up a network of pharmacies would have to cover the full retail price that the customer paid—which could be more than $12 per test.

Mina Bressler, a mother of two and a therapist in San Mateo, California, was able to buy rapid test kits online and shared some with a parent who works in the service industry and doesn't have time to "sit at her computer every hour refreshing the Walmart page to see when tests are in stock."

"I gave her some and her kids went to school. That's one time and there's a million of her," Bressler told the AP.

"Just like vaccines becoming available really shone a light on the inequity of what's going on in this pandemic, I think testing is the new flashlight for that because who's going online stalking Walmart? It's not the most vulnerable people in the county," Bressler added.

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 are not on a covered insurance plan can receive free tests through the forthcoming federal website or from some local community centers and pharmacies.

The Associated Press contributed to this report.