Biden Admin to Require Insurance Carriers to Cover At-Home COVID Tests
Biden’s administration has officially announced that insurance carriers, beginning on Jan. 19, are required to provide reimbursement coverage for at-home COVID tests. There have been many questions about this new measure, such as the exact amount of the reimbursement, where tests can be purchased, and exactly how many tests will be covered.
All of these factors can affect your employees and the safety of your workplace. Read on to learn exactly what this new mandate entails, and how your employees can receive reimbursement for their next at-home test.
How Does This Affect Your Organization?
This new COVID mandate should help to promote a safer working environment by allowing for greater testing accessibility for your employees. In addition, by providing at-home tests at no out-of-pocket cost, you eliminate the financial constraint that may be deterring employees from getting tested more regularly. For this measure to be effective, however, proper communication will be key. Make sure that your employees are educated on the finer points of this mandate in order to claim their full reimbursement.
Another good organizational practice would be to send reminders to employees encouraging them not to delay ordering tests. This way, if an employee is feeling sick, they will have immediate access to learning whether they have contracted the virus.
HR should also look to revisit their current COVID policies to see if they need any revisions. If any revisions are required, communicate these updates effectively to employees so that all team members are on the same page regarding the organization’s COVID policy.
How Much Will Be Reimbursed?
According to Biden’s plan, insurance companies will be required to reimburse up to $12 per individual per test. For the purpose of insurance reimbursements, a box that contains multiple tests will be viewed as one test.
Tests generally run somewhere between $10 and $15 each. That said, some tests cost upwards of $20 or $30, such as the BinaxNOW from Walgreens or the On/Go kit being sold by Amazon and Walmart. Typically, test boxes contain two individual tests.
Be sure to communicate these prices to your employees so that they can take advantage of the full reimbursement.
Where Can You Purchase an At-Home Test?
Employees will be eligible, as of Wednesday, Jan 19, to purchase at-home tests directly from COVIDTests.gov. The White House has stated that these tests will be shipped via the postal service and should take approximately 1-2 weeks for delivery. Biden has stated he plans to make 1 billion tests available throughout the country.
Other buying options include local stores such as Walgreens, CVS, Walmart, or your local pharmacy. The White House has given insurers the go-ahead to create a list of in-network and out-of-network pharmacies and retailers to work with. This means that if your insurer lists a specific pharmacy as in-network, you will be eligible for reimbursement when purchasing a covid at-home test from that retailer.
When communicating to your team, be sure to educate them on this new list of network providers and encourage them to explore the list before buying an at-home test. Should an employee purchase a test from an out-of-network provider, it is possible that they will not receive the reimbursement.
Will Employers Need to Change Their COVID Policy?
Due to the new mandate, employers may wish to alter their current COVID policy surrounding testing. In addition, organizations may want to offer a wellness credit to incentivize employees to order these tests. This could look like, showing HR a receipt for the first purchase of an at-home test, and then receive a one-time discount on their monthly insurance premium.
Can You be Reimbursed for Previously Purchased Tests?
This has not yet been established so the likelihood is quite low. According to CMS.gov, there are no federal laws that require insurers to provide coverage for any at-home tests purchased prior to January 19, 2022.
Should employees wish to inquire further, it would be most helpful to reach out to their health care provider to determine what the policies are. HR should keep employees apprised of this information as well, so that they may purchase tests after the mandate goes into effect.
How Many Tests Will Be Covered?
According to CMS.gov, health plans are required to cover up to 8 individual at-home tests per person(s) enrolled in the plan per month. Generally, there is no limit to the number of tests that may be reimbursed when administered by a medical provider.
Can you be Reimbursed If You Lack Insurance?
Biden has stated that there will be thousands of locations offering at-home tests for those who lack insurance. Individuals who lack insurance are also able to visit local health clinics to receive a test. There is a search tool offered by the Department of Health and Human Services that can help you find a site where you can take a test.
The Department of Health and Human Services has also implemented a program that provides over 10,000 local testing sites around the country. This is intended to ensure the availability of tests to populations and areas considered to be of high risk.
If you have employees who are not currently enrolled under a health plan, or perhaps a new employee who is not yet eligible for their benefits, then be sure to encourage them to utilize these resources until they are eligible to enroll in their new plan.
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