SYRACUSE, N.Y. — At-home COVID-19 test kits purchased over-the-counter will soon come at no cost for most Americans.
Starting Saturday, the federal government is requiring private insurances and group health plans to cover the cost upfront or reimburse purchases for people within their plan. Each covered person is eligible to get eight kits for free every month. For example, if there are three people in the insurance plan, that’s 24 total kits for the month.
People with Medicaid and Children’s Health Insurance Program (CHIP) programs are already required to get them for free. If someone has Medicare, they should check with their plan to see if it’s covered.
“This is to help prevent COVID-19,” Leslie Silva with Tully Rinckey PLLC said. “At this point, it’s not really a matter of getting reimbursed it’s a matter of actually being able to find a test.”
Municipalities across Central New York have distributed free at-home test kits at drive-through sites that are often gone within a short period of time. Finding them on store shelves isn’t proving any easier.
If the kit is purchased at a person’s pharmacy, for example, it should be as easy as checking out since insurance information is already on file. If they’re bought at another store, the insurance company will reimburse the purchase after a claim has been submitted. How long it will take to get the money back is uncertain.
“You may be billed for this and you may have to then address that with your insurance company later,” Silva said.
If the kits are purchased out-of-network, insurance will only cover up to $12 for each kit. Purchasing them online may be considered out-of-network. The kits are only free if they are cleared, approved, or authorized by the FDA. That list can be found here.
Only eight per insured person per month means people will have to watch out for how many they buy.
“If you have a family plan and you have four people on your family plan, that’s a good indicator that there’s four people in your house and that should be where they’re making the basis,” Silva said. “They may put an alert through their system that you then have to pay out-of-pocket if you’ve maxed out the amount of tests that you’ve received that month.”