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January 14, 2022

Health Law Weekly

Administration Requires Insurers to Cover At-Home COVID-19 Tests

  • January 14, 2022

The administration announced this week that it is requiring private insurance companies and group health plans to cover the cost of at-home COVID-19 tests starting January 15.

The move is part of the administration’s effort to expand consumer access to free testing. The Department of Health and Human Services (HHS) said insurers must cover eight, free over-the-counter at-home tests per covered individual per month, meaning a family of four on the same plan would be able to obtain up to 32 at-home covered tests per month. There is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider, HHS said.

The requirement encourages insurers and plans to cover the costs of the tests upfront by establishing a network of preferred pharmacies and retailers. Insurers and plans must still reimburse consumers for tests they buy outside of the network for up to $12 per test.

“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated. Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people,” said Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure.

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  • Coronavirus Pandemic Hub