UPDATE: People covered by Medicare or Medicare Advantage will be able to get free, over-the-counter COVID-19 tests starting in early spring, the Centers for Medicare & Medicaid Services (CMS) announced on Feb. 3.
Under this new program, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month at no cost. CMS says the tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA). A CMS spokesperson told VERIFY more information about eligible pharmacies and other entities participating in this initiative will be available soon.
PREVIOUS REPORTING: As the omicron variant of COVID-19 surges across the United States, the Biden administration is working to increase access to testing for millions of Americans. In December 2021, President Joe Biden announced the federal government’s plan to purchase 500 million rapid COVID-19 tests that would be available for free to every person who requests them starting in January.
Since Biden’s announcement, the Department of Defense has awarded contracts to multiple companies to help with the delivery of the tests. Biden later said in a Jan. 13 tweet that he has directed his team to purchase an additional 500 million free tests. Americans will be able to request the free tests online at COVIDtests.gov beginning on Jan. 19, according to the White House.
The administration has also announced other ways Americans can get free tests, including through reimbursement from private insurance companies. Here’s how it works.
Are private insurers now required to cover the cost of at-home COVID-19 tests?
Yes, private insurers are now required to cover the cost of at-home COVID-19 tests.
WHAT WE FOUND
Starting Jan. 15, private insurance companies and health plans are required to cover the cost of up to eight at-home COVID-19 tests every month for each person covered under the policy, according to the White House and the U.S. Department of Health and Human Services (HHS). For example, a family of four will be able to get up to 32 tests per month if they are all on the same insurance plan.
The Biden administration says it is incentivizing insurers and group health plans to set up programs that allow people to get the tests directly at pharmacies, retailers or other entities with no out-of-pocket costs. This means insurers would cover the costs upfront, which would eliminate the need for individuals to submit a claim for reimbursement. There is no limit on the number of tests that are covered if they were ordered by a health care provider, according to HHS. This includes at-home tests.
“Under President Biden’s leadership, we are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost,” HHS Secretary Xavier Becerra said.
Individuals covered by Medicare will not be able to get their at-home COVID-19 tests reimbursed through this program, according to the Centers for Medicaid & Medicare Services (CMS). However, Medicare Advantage plans may offer coverage and payment for at-home COVID-19 tests. Currently, the CMS says HHS is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. On Feb. 3, the CMS announced a new initiative that would allow people on Medicare or Medicare Advantage to get free, over-the-counter COVID-19 tests starting in early spring. State Medicaid and Children's Health Insurance Program (CHIP) plans are already required to fully cover the cost of at-home tests.
Private insurance companies, like Aetna, Blue Cross Blue Shield Association and Centene, along with America’s Health Insurance Plans (AHIP), a national trade association of health insurance companies, released statements saying they are working to implement the Biden administration's new testing requirements.