WASHINGTON - Starting Saturday, private health insurers will be required to cover up to eight home COVID-19 tests per month for people on their plans. The Biden administration announced the change Monday as it looks to lower costs and make testing for the virus more convenient amid rising frustrations.
"Today, our administration announced that beginning January 15, 2022, individuals covered by a health insurance plan who purchase an FDA-approved, over-the-counter COVID-19 diagnostic test will be able to have those tests covered by their insurance," White House posted in a tweet.
Under the new policy, Americans will be able to either purchase home testing kits for free under their insurance or submit receipts for the tests for reimbursement, up to the monthly per-person limit. 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.
The insurer-covered testing would dramatically reduce costs for many Americans, and the administration hopes that easing a barrier to more regular at-home testing can help slow the spread of the virus, get kids back into school more quickly and help people gather safely.
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.
There was no immediate reaction from insurers or details yet on potential insurer and retailer partnerships ahead of Saturday’s effective date.
Only tests purchased on or after Jan. 15 will be required to be reimbursed, the administration said. Some insurers may choose to cover the costs of at-home tests purchased earlier, but they won’t have to.
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.
More than a year after the vaccine was rolled out, new cases of COVID-19 in the U.S. have soared to their highest level on record at over 265,000 per day on average, a surge driven largely by the highly contagious omicron variant.
New cases per day have more than doubled over the past two weeks, eclipsing the old mark of 250,000, set in mid-January 2020, according to data kept by Johns Hopkins University.
The number of Americans now in the hospital with COVID-19 is running at around 60,000, or about half the figure seen in January, the Centers for Disease Control and Prevention reported.
While hospitalizations sometimes lag behind cases, the hospital figures may reflect both the protection conferred by the vaccine and the possibility that omicron is not making people as sick as previous versions.
COVID-19 deaths in the U.S. have climbed over the past two weeks from an average of 1,200 per day to around 1,500.
The Associated Press contributed to this report. This story was reported in Los Angeles.