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January 11, 2022

At-home COVID-19 tests soon will be covered by health insurance

Insurers must cover the cost up front or allow people to submit claims for reimbursement, White House says

Americans who have private health insurance or are enrolled in group plans no longer will have to pay for at-home COVID-19 tests beginning Saturday. 

The U.S. Department of Health and Human Services is requiring all private insurance companies and group health plans to make over-the-counter COVID-19 tests available for free. The move will affect about 150 million Americans. 

Health plans must cover the cost of the tests at the time of purchase or allow members to submit claims for reimbursement. Plans must cover up to eight tests per person each month. 

Insurers must reimburse consumers for tests purchased outside of their health care networks. Reimbursements will be worth up to $12 per test. 

Consumers will need not an order from a health care provider, or be required to undergo a clinical assessment. Cost-sharing requirements, including deductibles, copayments or coinsurance, will not be necessary. 

All at-home COVID-19 tests approved or authorized by the U.S. Food and Drug Administration will be covered. 

The Biden administration is encouraging insurers to set up programs that allow consumers to receive tests directly from their preferred pharmacies. This would eliminate the need to submit claims for reimbursement.

The directive comes as the White House coordinates a federal effort to push back against the omicron variant, which has fueled a massive spike in cases. 

The entire country is currently experiencing high levels of COVID-19 transmission, according to the U.S. Centers for Disease Control and Prevention. More than 4.7 million infections have been recorded over the last seven days. More than 29% of tests administered over the past week have come back positive.

President Joe Biden's response to the omicron variant calls for distributing 500 million free, at-home COVID-19 tests. White House Press Secretary Jen Psaki said people should be able to order the tests online later this month. 

The White House also is delivering 50 million rapid tests to rural clinics and community health centers.

New Jersey residents can order free, at-home COVID-19 saliva tests through a partnership between the state health department and Vault Medical Services.

Biden's strategy also includes setting up new COVID-19 testing clinics operated by the Federal Emergency Management Agency. Federally-run testing sites opened last week in Southwest Philadelphia and North Jersey.

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