The Biden-Harris Administration requires insurance companies and group health plans to cover the cost of over-the-counter, at-home COVID-19 tests beginning January 15, 2022, as part of its ongoing efforts to expand Americans’ access to free testing.
The new mandate will allow most people with private health insurance to buy tests online or in person and either have it paid for upfront by their health plan or have the money repaid by claiming reimbursement.
The hope is that insurance companies will be incentivized to cover the costs of the tests upfront without the need to fill out a reimbursement claim to make getting an at-home test an easier process.
According to the new mandate, insurance companies and health plans are required to provide up to 8 free at-home tests per person per month.
Example: A family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan per month. (HHS.GOV)
What Is an At-Home Covid-19 Test?
An at-home Covid-19 test, also known as a rapid test, OTC (over the counter), or antigen test, is designed to identify specific proteins on the virus’s surface and is used to diagnose an active coronavirus infection.
The insurance companies are covering these tests for diagnostic purposes only. Meaning, If you have come into touch with someone or are experiencing symptoms of Covid-19, it is advised to isolate at home and wait 3-5 days before taking the test to ensure the virus is found.
How to Get Reimbursed for Your At-Home Covid Test Kits in New Hampshire
Health Insurance companies across the United States are working to implement the new requirements provided by the White House.
Health insurance providers will work as quickly as possible to implement this guidance in ways that limit consumer confusion and challenges.
Matt Eyles, president, and CEO of America’s Health Insurance Plans
Ambetter from New Hampshire Healthy
Ambetter’s FAQ page states that they provide free at-home testing kits to their members with no upfront cost through pharmacies in their network. Common participating pharmacies are CVS and Rite Aid. For a full list of in-network pharmacies, click here.
If you decide to purchase a kit outside of the approved network of pharmacies, you can still get reimbursed. To start the reimbursement process, fill out the member reimbursement form.
Ambetter will reimburse you up to $12 per test per covered member. In addition, if you purchased a test kit before January 15, 2022, Ambetter will still reimburse you if you include a physician prescription.
Anthem Blue Cross and Blue Shield of NH
On Anthem’s FAQ page for at-home Covid-19 tests, they state that they have a limited number of at-home diagnostic test kits available. Therefore, the members recommend logging in using the SydneySM Health mobile app or at anthem.com to find out if they are eligible. If you qualify, you will see the option to order a test kit. If you are not eligible, you will not see that option.
Members who are not eligible to purchase directly from Anthem can be reimbursed by submitting a claim online. To submit a claim, you will need to log into your account on the website, go to Claims & Payment and select Submit a Claim.
If you have an Anthem Medicaid or Medicare plan, you will need to visit your member website for information on how you can receive free Covid-19 testing.
Harvard Pilgrim Health Care
Harvard Pilgrim Health Care is covering the cost of up to eight at-home tests per member per month. In addition, they will pay for tests approved by the FDA or granted emergency use authorization.
Antigen Tests that are FDA approved or have EUA are:
- BD Veritor At-Home COVID-19 Test
- BinaxNow COVID-19 Ag Card Home Test
- restart COVID-19 Antigen Home Test
- Celltrion Dia Trust COVID-19 AG Home Test
- CLINITEST Rapid COVID19 Antigen Self-Test
- COVID19 At-Home Test
- Ellume COVID-19 Home Test
- Flowflex COVID-19 Antigen Home Test
- iHealth COVID-19 Antigen Rapid Test
- InteliSwab Covid-19 Rapid Test
- QuickVue At-Home COVID-19 Test
- SCoV-2 Ag Detect Rapid Self-Test
To view a full list of eligible tests, click here.
Members can visit any Walmart or Rite Aid pharmacies to purchase tests with no upfront cost.
If you have purchased a test with your own money on or after January 15, 2022, you can be reimbursed after printing and mailing this form.
For members of a self-insured employer group, Harvard Pilgrim suggests that you follow up with your employer to confirm your coverage options.
Free at-home testing kits or reimbursements are not currently available to Medicare members, but Harvard Pilgrim is working with CMS to see if they can provide that service as well.
Additional Important Information
The State of New Hampshire launched a program by the NH Department of Health and Human Services (DHHS) where its residents can order free at-home tests kits and have them delivered to their homes while supplies last. To learn more, click here.
If your insurance does not cover the cost or allow you to receive a reimbursement, you can still receive free at-home testing kits through the government’s program, where every citizen can order four free tests per household. To learn more, click here.
You can also get free at-home tests from community health centers and Medicare-certified health clinics.
