The state of Delaware is looking to expand options for COVID-19 testing and detection through the introduction of home testing self-services. As a result, the Division of Public Health is prioritizing this testing method. The at-home testing method is available to all Delaware residents, and if one is ordering for a family, they will need to use one email address per person or test. The at-home testing uses saliva collection, the same as the nasal swab lab test. This test will be performed under the supervision of Vault Healthcare provider via zoom telehealth visit, therefore, eliminating the risk of person-to-person exposure. To order these tests, residents are required to register with the state of Delaware government. Once registered, one required to submit a request, and they will be able to receive a response within 2 to 3 working days. If approved, the resident will receive a link to Vault Health with a test code number. The test will be received the following day. To perform the tests, a zoom app is needed as the saliva collection will be supervised, then one is required to ship the test at no cost to a UPS box, and the report of the results will be made available via mail within the next 48 to 72 hours (Delaware Division of Public Health, 2022).
Earlier this year, the Biden administration required private insurers to cover the cost of the at-home rapid test at no cost to their members (Highmark Blue Cross and Blue Shield of Delaware, 2022). Therefore, this report will discuss how insurers in Delaware state have implemented this directive.
How To Get Reimbursement
Highmark Blue Cross and Blue Shield of Delaware (BCBSDW)
The Biden administration announced federal guidance on COVID-19 testing. Accordingly, the Highmark BCBSDW provides coverage for at-home, over-the-counter diagnostic tests, that are emergency-use authorized by Food and Drug Administration and are eligible for reimbursement (Highmark Blue Cross and Blue Shield of Delaware, 2022).
Highmark BCBSDW members can request reimbursement for up to eight tests per member per month. Members can also use the existing pharmacy network to eliminate the need for reimbursement. The Highmark BCBSDW members with individual health or employer-sponsored plans are eligible for reimbursement, but Highmark Medicare Advantage enrollees are not (Highmark Blue Cross and Blue Shield of Delaware, 2022).
Members should locate the 6 FDA authorized tests like Binaxnow COVID-19 AG Home Test, Ellume COVID-19 Home Test, Flowflex COVID-19 AG Home Test, iHealth COVID-19 AG Home Test, InteliSwab COVID-19 Home Test, and QuickVue At-Home COVID-19 Test at an in-network pharmacy. Then show their Highmark insurance card to have the test processed through their pharmacy benefit (Highmark Blue Cross and Blue Shield of Delaware, 2022).
When submitting a request for OTC tests reimbursement, members must submit the following documents (Highmark Blue Cross and Blue Shield of Delaware, 2022):
- Completed Member Submitted Health Insurance Claim Form.
- Itemized receipt for over-the-counter tests with purchase date on or after 1/15/2022.
- Original or photocopy of 12-digit UPC (Universal Product Code) label from purchased over-the-counter tests.
Members can then mail the claim form to the address provided on the form or otherwise complete an online submission process available at the Highmark website. It will take 30 up to days for claim processing and payment to be issued (Highmark Blue Cross and Blue Shield of Delaware, 2022).
Additional information
In early spring, Medicare will be able to cover the cost of over-the-counter at-home rapid COVID-19 tests, according to the announcement made by the Center for Medicare and Medicaid Services. Therefore, Americans enrolled in either Medicare Advantage or Medicare will be able to pick up to eight tests per month for free through participating entities and eligible pharmacies (Crist, 2022).
The policy applies to OTC rapid tests authorized or approved by FDA. In addition, the new policy will require Medicare to pay health care providers and participating pharmacies directly. As a result, this will eliminate the need for reimbursement. In the recent Biden administration push to direct private insurers to cover OTC at-home tests, 64 million Medicare beneficiaries were excluded. The announcement, therefore, came as a result of various criticisms from health care experts and lawmakers (Crist, 2022).
The expanded access to at-home testing with no cost will help protect seniors at much risk of severe illness or death from COVID-19. The announcement has, however, not indicated the number of health care providers and pharmacies that will participate. Until then, the CMS said that people with Medicare can still access free tests by requesting four over-the-counter tests for home delivery at COVIDtests.gov. Also, COVID-19 tests can be accessed through healthcare providers at more than 20,000 free testing sites across the US. A list of sites is available on the U.S. Department of Health and Human Services website. Further, one can get free lab-based PCR tests and antigen tests performed when it is ordered by a doctor, non-physician practitioner, pharmacist, or other authorized health care professional (Crist, 2022).
Besides, Americans can always use self-tests before joining indoor gatherings or regardless of vaccination status or when you show or not show symptoms. Also, to obtain accurate results, an individual should follow all the instructions put forward by the manufacturer. If an individual test positive for COVID-19, they should isolate or use a well-fitting mask if they must be around people. And if the results are negative, repeating the self-test within some few days will increase the confidence that you are not infected with the virus (CDC, 2022).
Conclusion
In the state of Delaware, only Highmark Blue Cross and Blue Shield Delaware provides coverage for at-home rapid tests as other private insurers have no information regarding the same. Highmark provides coverage for eight FDA authorized rapid tests. Members can then purchase the test kit at an in-network pharmacy to avoid submitting a reimbursement request. If the at-home test requires one to submit a reimbursement form, members can do so either online or manually. Members should, however, make sure they attach proper documentation such as receipts as proof of purchase. Also, it is essential to note that beginning this spring, Americans covered under Medicare will be able to obtain eight free OTC rapid tests at participating stores or eligible pharmacies. The announcement has, however, not provided the number of eligible health care providers or pharmacies.
References
CDC. (2022). COVID-19 and Your Health. Centers for Disease Control and Prevention. Retrieved 9 February 2022, from
Crist, C. (2022). Medicare Will Provide Free At-Home COVID-19 Tests Soon. WebMD. Retrieved 9 February 2022, from
Delaware Division of Public Health. (2022). Home Test Kit – Delaware’s Coronavirus Official Website. Delaware’s Coronavirus Official Website. Retrieved 9 February 2022, from
Highmark Blue Cross and Blue Shield of Delaware. (2022). Over-the-Counter Test Reimbursement – Highmark Answers. Highmark Answers. Retrieved 9 February 2022, from
