(NEXSTAR) – When omicron began to take off in the United States, the White House announced it would do more to help people access home COVID-19 testing. From Saturday, most of the plan so far takes effect.
Private health insurers are now required to cover eight home tests per month for each of their members.
Depending on when and where you purchase the home tests, which typically cost around $25 for a kit containing two tests, you may be able to get it covered by insurance on the spot, the Centers for Medicare and Medicaid Services say. .
But many people, especially in the early stages of the program, will have to pay for the tests out of pocket and then seek reimbursement from their health insurance.
If you’re paying out of pocket, you’ll want to keep your receipt as proof of purchase. You will need to file a claim with your health insurance company, not the federal government. (Call the number on your insurance card or check the company’s website for more information.)
Insurers are only required to cover kits purchased after Saturday January 15, so you may not have a chance of filing a claim for tests you purchased in the past.
The amount you can be reimbursed depends on whether your insurer has set up a “network of preferred stores, pharmacies and online retailers from which you can get a test at no cost,” says CMS.
If your insurance company has set up a way for you to take a test without paying upfront, you will receive up to $12 per test. If your insurer has not set up their own network or means for you to take the test through them, they will owe you the full cost of the test kit, even if it is more than $12.
“For example, if a person buys a two-pack for $34 and the plan or insurer has no system in place to cover the costs up front, then the plan or insurer will have to reimburse the $34 instead of $24,” CMS explains.
You won’t need to meet any type of deductible first in order to qualify.
Each insured person is entitled to eight tests per month. This means a married couple would be covered for 16 tests per month and a family of four would get 32.
Some people may be granted an exception to the eight-test limit by their doctor if more regular testing is needed for an underlying medical condition, for example.
The problem, for now, will be finding these home tests in stores. Many pharmacies and online retailers are always sold out or out of stock.
All of the above requirements only apply to those covered by private health insurance. People covered by Medicare, about 18% of the US population, will not be able to have the cost of home test kits reimbursed by their insurance plan.
However, those covered by Medicaid and the Children’s Health Insurance Program (CHIP) will be eligible for reimbursement, and they should check with their state program for details.
The government plans to distribute 1 billion rapid home tests, as well as N95 masks, directly to Americans. Anyone, regardless of health insurance status, will be eligible. Americans will also soon be able to register to receive a test by mail.
On Friday, the White House announced that the federal website where Americans can request free COVID-19 tests will begin accepting orders on Wednesday, January 19. Supplies will be limited to just four free tests per household.
The Associated Press contributed to this report.
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