Need Rapid Tests? Your Insurance Will Likely Pay for It
Did you know that health insurance covers the cost of eight home tests per beneficiary per month? Here’s how to get the tests you need — at no cost.
You just went to a party or spent a weekend with relatives, and now you’ve heard that someone who was there got sick. You need to test yourself in a few days. Rapid tests are available in most pharmacies, but they aren’t cheap, and you’re on a budget. What to do?
Your insurance (probably) covers home COVID-19 tests now.
As of January 2022, private health insurers must cover the cost of eight at-home tests per beneficiary per month, at up to $12 for each individual test. That’s potentially $96 in value for each person! If you have a family of four, you can get 32 tests valued at up to $384.
In the spring of that year, the program was expanded to provide coverage for those on Medicare Part B, Medicare Advantage, and certain Medicaid plans. For the vast majority of Americans, that means you can now get tests covered by your insurance company.
If you don’t have health insurance, don’t despair. You may be able to pick a few up at a nearby community health center or your local department of health. Military beneficiaries can get up to eight free tests per month at military hospitals or clinics. If you have a child in public school, check with your school nurse — some states have been giving schools lots of extra home tests and instructing school staff to give them away however they see fit.
How do I get these tests covered?
There are two ways:
1. Get the tests covered upfront.
Depending on what insurance you have, certain retailers may be able to bill the insurance company on your behalf when you get the tests. You can check with your local pharmacy and insurance company to see if this is an option for you. Medicare will only cover tests upfront — go to Medicare.gov for a partial list of participating pharmacies.
Last month, I got my eight tests from CVS.com. I put in my contact and insurance information and asked to have eight tests shipped directly to my home. It didn’t cost me anything, except for a small shipping fee. Walgreens provides a similar service, but the tests are only available for pickup in the store.
You might be able to order tests through your insurance company, too. For example, Blue Cross Blue Shield of Massachusetts provides the option to order tests through their mail order pharmacy partner.
2. Get reimbursed after you purchase tests.
If you have private health insurance, you can go to any pharmacy, big-box store, or online retailer to purchase your tests, but make sure to keep the receipt. Then you can submit the claim and receipt to your insurance company for reimbursement. Some insurance plans require you to submit the claim through the pharmacy benefit plan that partners with your insurance company. For example, Harvard Pilgrim, a regional insurer in New England, asks that you fill out a reimbursement form available from OptumRx.
Earlier this year, I got my month’s worth of tests from Walmart.com. I kept the receipt I was emailed and submitted it through my pharmacy benefit manager, CVS Caremark. The reimbursement check came in the mail a few weeks later.
Free tests won’t be available forever.
The government is requiring insurers to cover these tests while there is a Public Health Emergency for COVID-19. We don’t yet know when the Public Health Emergency will end, but when it does, your insurance may elect to stop covering tests.
Finally, make sure to visit WhenToTest.org’s COVID Risk Quiz to find out when you should use your tests.