Insurers to cover costs for at-home COVID tests starting Jan. 15th

On January 10, 2022, President Biden announced his strategy to expand access to free COVID testing, requiring all health insurers to cover costs for over-the-counter, at-home COVID tests starting January 15, 2022. Insurers will have to either cover the cost of the COVID home tests upfront or reimburse their members for the cost of tests once the member submits a reimbursement claim form.

How it Works:

  • Insurance companies will be required to cover eight (8) tests per covered person per month, starting after Jan. 15. People will not need a doctor’s order.
    • That means a family of four on the same plan would be able to access up to 32 tests per month for free.
    • There is no limit on the number of tests covered if they are ordered by a health care provider after a clinical assessment. This includes people who may need the tests due to underlying medical conditions.
  • Because people often have to wait an indefinite amount of time to get reimbursed, the Biden administration is pushing insurers and employers to set up programs that would give people direct access to tests with no out-of-pocket costs through pharmacies and retailers.
    • If an individual who has direct access through such programs purchases a test outside the network, insurers must reimburse them up to $12 per test.
    • This does not include people on traditional Medicare or the uninsured.
    • It does include Medicaid, and people with Medicare Advantage could also qualify depending on their plan.
    • The Biden administration is also providing up to 50 million free at-home tests to community health centers and Medicare-certified health clinics for distribution.

For answers to more of your questions on this topic, please view the tips from CMS by visiting: