Residence Covid-19 exams have to be paid for by well being insurers beginning Saturday
The brand new requirement signifies that most customers with non-public medical health insurance can purchase at-home exams on-line or in shops and have them paid for on the time of buy or get reimbursed by submitting a declare to their insurer.
Shoppers won’t want to go to their physician or get a prescription to acquire the free exams, the division mentioned. And the exams will not be topic to copays or deductibles.
Insurers should pay for as much as eight exams per coated particular person per 30 days. However there will not be any restrict if a health care provider orders or administers them after an workplace go to.
Insurers could arrange a community of most well-liked shops, pharmacies and on-line retailers, the place customers can obtain exams for free of charge up entrance. Individuals might nonetheless purchase exams outdoors that community, however insurers would solely must reimburse as much as $12 for each.
The requirement just isn’t retroactive, so at-home exams bought earlier than January 15 don’t qualify for reimbursement.
It’s organising a web site and hotline the place People can request the exams. Extra particulars must be accessible later this week, the White Home mentioned.
Well being insurers will work shortly, count on ‘hiccups’
Well being insurers will implement the steerage as shortly as potential and search to restrict customers’ confusion and challenges, Matt Eyles, CEO of America’s Well being Insurance coverage Plans, often known as AHIP, mentioned in an announcement.
“Whereas there’ll probably be some hiccups in early days, we’ll work with the administration to swiftly handle points as they come up,” Eyles mentioned, whereas reinforcing the significance of vaccines to combat the coronavirus.
One other main insurer business group famous the brief deadline to launch this system.
“We’re involved that the coverage doesn’t resolve for the restricted provide of exams within the nation and will trigger extra client friction as insurers get up a program in simply 4 days’ time,” mentioned Kim Keck, CEO of the Blue Cross Blue Defend Affiliation.
Medicaid and the Youngsters’s Well being Insurance coverage Program, often known as CHIP, already cowl at-home exams with no cost-sharing. Medicare covers at no cost Covid-19 testing performed in a lab when ordered by a medical skilled. These enrolled in Medicare Benefit plans ought to test with their insurers to see if at-home exams shall be paid for, HHS mentioned.
CNN’s Nikki Carvajal contributed to this story.