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Do insurance companies reimburse for “At-Home” COVID tests?

Published: Jan. 26, 2022 at 3:34 PM PST
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RENO, Nev. (KOLO) - We found a bin full of “At-Home” COVID tests at a CVS on McCarran earlier today. The cost: $9.99. There’s a limit of six per customer.

For those with insurance looking for reimbursement, ACA compliant tests must be covered.

“If it is ACA compliant, it is going to cover up to 8 tests per month that are the at-home tests,” says Alex Sampson with Health Benefits Associates. “The easiest way to getting it instead of buying it and then having them reimburse it is, just use a provider contracted out by the insurance company and just buy it through that provider or pharmacy,” he says.

It seems ironic then, the older patient who is more susceptible to the ill-effects of COVID and on Medicare will not get reimbursed for the “At-Home” test kits.

Traditionally the original Medicare will not pay for any “At-Home” test. However, in this case the federal health insurance for people over 65 has carved out a slight exception.

“They do have a list of tests so you can order and have them delivered,” says Sampson.

Traditional Medicare patients can also go to free standing test centers or clinics and receive tests there.

For Medicare Advantage patients, the results are a mixed bag. Some, but not all programs pay for the tests.

But they too have set a limit and costs.

“They are covering FDA approved tests,” says Sampson. “So that is very specific to reimbursement from the insurance company,” he says.

Of course all of this could be mute as the government is mailing out millions and millions of free “At-Home” tests to those who apply for them. One week after the program launched, tests are already being shipped out.

For questions Sampson says check websites, call phone numbers, or check with a broker for specifics.

And there’s another aspect to think about.

Sampson says Medicare and Medicare Plus programs could change their mind at any time.

It’s best to check the websites to see rules for “At-home” COVID test reimbursement.

healthbenefits.net

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