As the COVID-19 pandemic surge continues after the holidays, at-home COVID tests have been hard to come by. The tests are also expensive, running at around $25 for a set of two. Shortage in supply and high prices have deterred individuals from buying them.
Starting January 15th, 2022, the Biden-Harris Administration is requiring private insurance companies to cover the cost of over-the-counter at-home COVID test kits. People with private healthcare coverage will be able to get test kits with no out of pocket cost, or will receive reimbursement for the tests. So, individuals who purchase a test will either pay nothing at the store, or be reimbursed by their insurance later on.
The idea is to make tests more accessible, and encourage Americans to take the tests when needed. As insurance companies figure out how to tackle this, each state’s insurance companies will have different rules and requirements for plan members to receive reimbursement. Let’s look at how COVID-19 test reimbursement is going to work in Hawaii.
Who is Eligible?
According to the Health and Human Services Department, only Hawaiians with private insurance will be able to receive this reimbursement benefit. Individuals on Medicare will be unable to receive this benefit, but they can order free at-home tests through the government website.
How to Get Reimbursed for Covid Tests in Hawaii by Provider
As insurance providers roll out reimbursement rules, each one is handling it differently. Some are working on system updates to allow online claims, and others are going to cover the cost at preferred retailers. Individuals can check with their insurance provider to find information on how they are handling this new coverage.
University Health Alliance
University Health Alliance, or UHA is currently working with a reimbursement model. COVID test reimbursement for Hawaii residents with UHA plans will only apply to personal use. Tests required for employment or travel will not be covered under the reimbursement benefit. The UHA website states that members may have to sign a document stating that they understand this distinction.
UHA is working to create a list of preferred retailers where members will be able to purchase a test with no out of pocket cost. According to their website, this list will include CVS Longs and Walmart pharmacies. Since they are still working on this system, members can purchase tests and UHA will reimburse them for up to $12 per individual test on FDA-approved kits.
It is important for members to save their receipts and bar codes to fax them to Express Scripts to file their claims. Taxes and shipping for online ordered tests will not be covered. Members must file their claims within 90 days of purchase to receive reimbursement.
United Healthcare
Residents of Hawaii enrolled in UnitedHealthcare commercial plans can fill out this form to receive test reimbursement. They can also purchase tests with no out of pocket cost at one of United Healthcare’s preferred retailers. This list includes Walmart pharmacies, Sam’s Club and Rite Aid.
Kaiser Permanente Commercial Plans
Kaiser Permanente is currently only doing reimbursement post purchase. Plan members must submit their claims online here. They will need to save their receipts and barcodes to submit a claim, and have 90 days from the date of purchase to do so. If you are unsure if you have a private plan through Kaiser, contact them today to see if you qualify for reimbursement benefits. You may be able to log into an online portal to find out, as well.
Hawaii Medical Service Association
For those with HMSA private insurance plans, they are operating on a reimbursement system and are still working on a portal to submit claims. Members are encouraged to keep their receipts and bar codes while they update their systems.
How Many Tests Will Be Covered?
The Biden-Harris Administration is requiring health insurance companies in Hawaii to cover 8 over-the-counter FDA approved COVID tests per individual. This means that a family of four can receive up to 32 free tests a month.
If an individual has an underlying medical condition that requires them to test often, there may be no limit to how many tests they can get a month. Insurance companies are required to cover up to $12 per individual test during reimbursement, or cover the full cost through preferred retailers.
Are Tests Purchased Before January 15th Covered?
No, tests purchased before January 15th will not be retroactively covered in Hawaii. Insurance companies are only required to cover the cost of tests purchased on or after January 15th.
What Kind of Tests are Covered for Reimbursement?
The Biden-Harris Administration is requiring insurance companies to cover the cost of at-home over-the-counter rapid COVID test kits. All types of at-home tests are to be covered, including:
- Quidel’s Quickvue Antigen Test
- Abbott’s BinaxNow At-Home Test
- Orasure’s InteliSwab Rapid Test
- All other at-home brands
Where Can I Buy Them?
Due to the shortage in test supply, they can be hard to come by in brick and mortar stores. Typically, the at-home tests can be purchased at any pharmacy such as CVS, Walmart and Rite Aid. You can also purchase tests online, but check with your insurance provider to see if they cover the cost of shipping.
Will I Automatically be Reimbursed for the Full Amount of the Tests?
Yes, insurance companies are required to reimburse for the full amount that the manufacturer’s charge. Currently, most insurance providers are encouraging individuals to purchase FDA-approved tests that are $12 or less for each individual test. This is the recommendation for the government for covered amounts.
Will the CDC Reimburse for COVID Tests?
No, the CDC will not be reimbursing for COVID tests, and all coverage is up to insurance providers. Rapid tests are still not being accepted for travel, and CDC requires travelers to get a PCR test.
Additional information on COVID Test Reimbursements in Hawaii
Many Hawaii residents are members of Medicare and Medicaid. It is important to check with your insurance company to see what is covered and how to get free tests.
