January 15 was a big day for people looking for at-home COVID test kids. The Biden-Harris Administration implemented a program in which insurance companies will be required to cover over-the-counter at-home COVID test costs. This will either come in the form of COVID test reimbursement or pairing with pharmacies so members can receive tests with no out-of-pocket cost.
At-home COVID tests have been in high demand and hard to come by. Not only that, they are pricey. A set of two tests can cost around $25, which could deter Connecticut residents from adhering to testing guidelines recommended by the CDC. At-home tests once lined the shelves, and they have become short in supply recently due to the rising popularity in this type of test for personal use.
The program will make at-home testing easy and accessible to insurance plan members, which will hopefully encourage people to test as needed. With such quick implementation, insurance companies need to work out plans while also honoring current reimbursement. Insurance reimbursement for COVID tests must stretch back to January 15, so individuals can submit claims for previously purchased kits. Each insurance provider in Connecticut is handling the program differently, so let’s look at how they’re doing so.
How Does COVID Test Reimbursement Work?
The program works the same across the country, with each state doing things a little differently. All insurance companies are required to cover the cost of 8 at-home rapid COVID tests per individual. Typically, the tests come in a set of two, and each test would count. For retroactive reimbursement, insurance companies are only required to cover up to $12 per individual test. So, for the tests priced around $25, individuals may not receive full reimbursement.
Tests must be FDA-approved to be covered, and purchased from approved retailers. They cannot be purchased from third-party sellers like Facebook Marketplace. COVID tests must also be for personal use. Kits for employment and travel will not be covered by insurance.
At this time, tests from all major retailers will be covered. As long as you have the receipt to prove you purchased the test, your insurance should reimburse you.
A question that has come up is if the CDC will reimburse for other types of test kits. The answer is no, they will no. Tests required for travel must be paid out-of-pocket by the individual as well as for employment, although employers may cover that cost. This program is specifically for personal use tests.
It’s important to hang on to your receipts and any proof of purchase for reimbursement. Some companies may require you to send in part of the packaging as well. Again, each insurance company is crafting its own plan going forward as long as it adheres to the Biden-Harris Administration requirements.
Ideally, insurance companies will work with pharmacies to create preferred networks of retailers that members can visit to obtain a COVID test at no out-of-pocket cost. Some have been able to do this, while other plans are still working on it. It’s a difficult task to implement a new system so quickly.
Who is Eligible for Insurance Reimbursement for COVID Tests?
The program is for those who have commercial or private insurance plans. That means those who have insurance through their employer should be covered. Individuals who have purchased an insurance plan through the Affordable Care Act Marketplace will also be eligible. If you’re unsure about your coverage, consult with your insurance provider to figure out if you fall into this category.
Currently, Medicare plan members will not receive coverage through this program. Those with Medicare should consult with their providers to see what’s available to them. Medicaid and Medicare plan members should utilize the COVID test website to order free tests and have them delivered.
When Should I Get Tested?
While at-home COVID testing is important, the 8 test limit means you won’t be able to test yourself every day for free. You’ll need to use them sparingly to ensure you receive reimbursement for COVID tests.
According to the CDC, there are several times individuals should get tests. If you are experiencing symptoms of COVID, you should have someone else go and purchase a test for you or have it delivered. The CDC recommends that those who have come in close contact with someone who has COVID should be tested at least 5 days after the contact. The day they were exposed is considered day 0.
Utilizing your insurance reimbursement for COVID tests is a great way to keep yourself and your family safe after exposure. Each insurance provider in Connecticut is doing what they can to make the process as easy as possible.
How to Get Reimbursed for COVID Tests in Connecticut By Provider
Connecticare
Connecticare commercial plan members will need to save their receipts and submit a claim form on Express Scripts. Members are also subject to having to sign an attestation stating that the tests were for personal use when they submit the claim. Members are encouraged to check their plans to ensure they are eligible for COVID test reimbursement.
BCBS Anthem
BlueCross BlueShield Anthem members will be reimbursed for at-home COVID tests purchased on or after January 15. If you pay out-of-pocket, members are directed to keep their receipts and submit them when they file a claim. All claims should be filed online through the member portal. Currently, Medicaid and Medicare members will need to check their plans for coverage information.
Since BCBS is a national company, they are currently working on a massive network of preferred retailers for no-cost COVID tests. When this is implemented, plan members will be able to visit a store and obtain a test without paying anything upfront. Until then, reimbursement is the only method.
Additional Information on COVID Test Reimbursement in Connecticut
The bottom line is getting tested is extremely important for safety. This program is intended to help individuals acquire at-home COVID tests without financial strain. Free COVID tests can be delivered to your door from the government website at any time, as well.
