President Biden announced new actions that aim at protecting Americans and helping hospitals and communities battle the new Omicron variant. First, the federal government launched a new website where Americans can request up to four free COVID-19 at-home rapid tests per household. In addition, the administration will buy one million at-home COVID-19 rapid tests so that citizens can begin ordering them online at COVIDtests.gov. The rapid tests should be shipped through the United States Postal Service between 7 to 12 days (White House, 2022).
The Biden administration also announced that beginning January 15, 2022, private insurance providers would be required to cover the cost of up to eight rapid COVID-19 tests per individual per month. The administration also aims at making sure members of the hardest-hit communities will have a hotline whereby they can access free tests if they do not have internet access.
The new federal policy requiring private insurers to cover at-home rapid tests meant that the policyholders would be able to buy home tests in stores or online and have them paid for or get reimbursement with a claim. Most private insurance companies have adopted the policy. However, test kits shortage poses a challenge to fully implementing the emergency rule. Louisiana is one of the many states affected by the shortage of test kits (Figueroa, 2022).
How To Get At-Home Over the Counter Tests Louisiana State
Health plans with direct coverage plans will have their members purchase the rapid tests free at the point of sale. Health plans with no direct coverage require members to pay out of pocket and seek reimbursement. However, the insurance companies are required to reimburse a maximum amount of $12 per individual test.
When one cannot afford to pay upfront
Insurers and health plans have been incentivized to set up a network of preferred retailers and pharmacies so that covered members can walk-in or order online at home COVID-19 tests for free rather than undergoing a long process of seeking reimbursement. Free testing can also be accessed at local community clinics.
What if one is uninsured?
The Biden administration will be purchasing 500 million OTC at-home rapid tests to be freely distributed to all Americans who need them. In addition, the United States (US) Department of Health and Human Services (HHS) will provide up to 50 million free test kits to community health centers and Medicare-certified health clinics for distribution at no cost to community members. HHS, moreover, established more than 10000 free community-based pharmacy testing sites to respond to the Omicron surge.
How To Get Reimbursed
If health plan enrollees are charged for tests bought, they must keep their receipts and submit a reimbursement claim form (CMS, 2022).
Blue Cross and Blue Shield of Louisiana
The Blue Cross and Blue Shield of Louisiana will continue to define their process for covering the over-the-counter at-home rapid test required by the federal government. However, the general rule regarding reimbursement of such tests at Blue Cross and Blue Shield Association requires that plan members pay out of pocket and file for reimbursement. The reimbursement process involves; saving the purchase receipt and cutting out the UPC on the test box, downloading and printing the reimbursement form, and mailing the form along with a receipt and UPC to the address on the form.
The processing standard for claims is in 30 days. The status of members’ claims can be viewed by logging in to My Health Toolkit. The reimbursement is sent in the form of a check. Blue Cross and Blue Shield of Louisiana will also reimburse other expenses, including shipping and sales tax. Therefore, members are encouraged to include them with their documentation. The company does not cover OTC tests bought before January 15, and members do not need a doctor’s prescription to qualify for a covered OTC test.
The type of test must be cleared, approved, and authorized by the US FDA, including InteliSwab COVID-19 Rapid Test, SCoV-2 Ag Detect Rapid Self-Test, and BinaxNOW COVID-19 Ag Card Home test (Blue Cross and Blue Shield, 2022).
How Long Does It Take to be Reimbursed?
The private and health plans are encouraged to provide prompt reimbursement for claims for OTC at-home rapid COVID-19 tests, and members are required to determine how their claim process works from their plans. The number of tests a member can be reimbursed is eight tests per individual member. Insurers are not required to provide coverage of at-home rapid tests for employment purposes.
Individuals covered by the original Medicare fee for service, the Medicare will pay for COVID-19 diagnostic antigen tests performed by a professional provider. Such tests include antigen and PCR tests with no cost-sharing when a physician orders the test. In addition, Medicare Advantage plans may offer payments and coverage for at-home COVID-19 tests (CMS, 2022).
The Center for Disease Control and Prevention recommended quarantine and isolation guidelines that need one to quarantine if exposed. Exposed individuals should stay away from others. In addition, people should isolate themselves if they are sick or test positive even if they show COVID-19 symptoms (CDC, 2022).
Additional Information
The new actions by president Biden aimed at protecting Americans and helping communities and hospitals battle the new omicron variant. First, the Biden-Harris Administration announced that starting January 15, 2022, private insurers will be required to cover FDA-approved at-home rapid tests with no cost-sharing. Most private insurers have adopted the policy, but a limited supply of at-home test kits hinders the full implementation of the policy. Covered members can now purchase or order theirs at home rapid test at retail stores or online. The number of tests covered is a maximum of eight per member per month, and the maximum amount an individual can be reimbursed for tests purchased out of network is $12 per test kit. Blue Cross Blue Shield of Louisiana will continue to define their reimbursement process. There was limited information regarding COVID-19 tests reimbursement in Louisiana.
References
Blue Cross and Blue Shield. (2022). Coverage for Over-the-Counter Tests. Myhealthtoolkit. Retrieved February 2, 2022, from
CDC. (2022). Quarantine & Isolation. Centers for Disease Control and Prevention. Retrieved February 2, 2022, from https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html.
CMS. (2022). How to get your At-Home Over-The-Counter COVID-19 Test for Free | CMS. Cms.gov. Retrieved February 2, 2022, from https://www.cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free.
Figueroa, A. (2022). Online orders for free at-home COVID tests to begin January 19 – Louisiana Illuminator. Louisiana Illuminator. Retrieved February 2, 2022, from https://lailluminator.com/2022/01/14/online-orders-for-free-at-home-COVID-tests-to-begin-jan-19/.
White House. (2022). FACT SHEET: President Biden Announces New Actions to Protect Americans and Help Communities and Hospitals Battle Omicron | The White House. The White House. Retrieved February 2, 2022, from https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/21/fact-sheet-president-biden-announces-new-actions-to-protect-americans-and-help-communities-and-hospitals-battle-omicron/.
