Chart Review: Private Insurance Coverage Of At-Home Rapid Covid-19 Tests

Yashashree Marne, Health Care Policy Intern

Following detailed guidance from the Biden Administration, private insurers are required to cover the cost of rapid at-home COVID-19 tests purchased over-the-counter as of January 15, 2022. The Kaiser Family Foundation recently published a review of such coverage and reimbursement policies for the 13 private insurers with at least one million fully insured members, which collectively cover about 60 percent of the fully insured commercial market. As of January 20, 2022, six of the top 13 private insurers offer direct coverage that allows enrollees to obtain rapid tests at any in-network or preferred pharmacy without paying anything. The remaining seven insurers rely on reimbursement policies that require enrollees to pay for tests upfront and subsequently file a claim online or by mail or fax; of these seven insurers without a direct coverage option, four require forms and receipts to be submitted by mail or fax, two require an online form, and one had not yet specified the method of reimbursement at the time of the survey, as shown in the chart below. Notably, three of the insurers that rely on reimbursement also require the Universal Product Code or product barcode from the box, creating an additional hurdle for customers seeking reimbursement. As AAF’s Christopher Holt previously outlined here, the ultimate outcome of this policy— for both the insurance industry and testing efforts in general—depends on the availability of tests and the ability of enrollees to navigate the reimbursement process.  
Source: Kaiser Family Foundation

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