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How to get insurance to pay for at-home COVID tests, according to the White House

David Dermer
A health worker grabs at-home COVID-19 test kits to be handed out last month in Youngstown, Ohio. Since Saturday, private health insurers have been required to cover up to eight at-home COVID-19 tests per month for those on their plans, the Biden administration announced last week.

Updated January 18, 2022 at 9:31 AM ET

Starting Wednesday, Americans will be able to order free COVID-19 tests online from the Biden administration, in a plan outlined last week. They're also now able to get reimbursements from their private insurance.

Individuals covered by a health insurance plan who purchase an over-the-counter COVID-19 diagnostic test that has been authorized, cleared or approved by the Food and Drug Administration have been able to have those test costs covered by their insurance since Saturday.

Insurance companies and health plans are now required to cover eight free over-the-counter at-home tests per covered individual per month, according to White House officials. For instance, 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.

"We are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost," Health and Human Services Secretary Xavier Becerra stated in a news release on Jan. 10.

This follows up on an announcement that the White House made last month.

During White House news briefing last week, press secretary Jen Psaki told reporters that the administration will start to have free coronavirus tests "out the door in the coming weeks."

"The contracts [for testing companies] are structured in a way to require that significant amounts are delivered on an aggressive timeline, the first of which should be arriving early next week," Psaki said.

The Biden administration says it is "incentivizing" insurers and group health plans to set up programs that will allow Americans to get the over-the-counter tests (PCR and rapid tests) directly through preferred pharmacies, retailers or other entities with no out-of-pocket costs.

For people whose health care providers have ordered a COVID-19 test, the Biden administration said there will not be a limit on the number of tests that are covered — including at-home tests.

Currently, state Medicaid and Children's Health Insurance Program (CHIP) programs must cover FDA-authorized at-home COVID-19 tests without cost-sharing.

Americans who are covered by Medicare already have their COVID-19 diagnostic tests, such as PCR and antigen tests, performed by a laboratory "with no beneficiary cost-sharing when the test is ordered by either a physician, non-physician practitioner, pharmacist, or other authorized health care professional," the Biden administration says.

At this time, those who are on Medicare will not be able to get their at-home COVID-19 tests reimbursed through the program, according to the Centers for Medicaid & Medicare Services. Currently, Medicaid and Children's Health Insurance Program plans are required to fully cover the cost of at-home tests.

Last year, the Biden administration issued guidance saying that both state Medicaid and CHIP programs must cover all types of FDA-authorized COVID-19 tests without cost-sharing.

Copyright 2022 NPR. To see more, visit https://www.npr.org.

Jonathan Franklin is a digital reporter on the News desk covering general assignment and breaking national news.