How to get reimbursed for an at-home COVID-19 test

Private health insurers will reimburse patients for eight at-home COVID-19 tests per month.

Tanza Loudenback

By

Tanza Loudenback, CFP®

Tanza Loudenback, CFP®

Contributing Reporter & Certified Financial Planner™

Tanza Loudenback, CFP® is a contributing reporter and Certified Financial Planner™ at Policygenius, where she covers personal finance and insurance news. Previously, she was a senior reporter and correspondent at Business Insider.

Updated|4 min read

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The Biden administration is forging ahead with plans to expand COVID-19 testing as the U.S. grapples with the quickly spreading Omicron variant.

Private insurers will start covering the cost of eight at-home COVID-19 tests per month, according to the Biden administration. More than 150 million Americans have private health insurance, either individually or through a group health plan offered by their employer, according to the White House. 

For Americans without health insurance and those covered by Medicare or Medicaid, the Biden administration said it will distribute 50 million free at-home tests to testing sites, community health centers, and rural clinics.

What is an at-home COVID-19 test?

An at-home COVID-19 test — also called a rapid antigen test or over-the-counter test — can be purchased at a pharmacy or online without a prescription. You can collect the sample yourself, or enlist the help of a family member, and expect a result within 15 minutes. 

These tests aren’t perfect. In November, the U.S. Food and Drug Administration recalled about 2 million at-home test kits from an Australian manufacturer because they were producing false positives. Still, the Centers for Disease Control and Prevention says at-home tests are a helpful “risk-reduction strategy” that can be used regardless of vaccination status or the presence of symptoms. The CDC recommends testing before gathering indoors with people you don’t live with.

The FDA’s online database shows there are currently 11 at-home tests authorized for emergency use.

How much does an at-home COVID-19 test cost?

Rapid antigen tests typically come in packs of two. Current prices at CVS, Walgreens, and Rite Aid range from $24 to $39. Walmart has a pack of two available for $14. 

Weekly at-home testing for a family of four can easily cost $200 a month. If you don’t have the cash to buy tests upfront, reimbursement through your insurance provider won’t be much help. It can take a long time to get a check from an insurance company, especially if submitting a receipt for reimbursement can’t be done online.

The New York Times reported reimbursements for at-home tests won’t cover past purchases. It’s unclear what the start date will be for reimbursement qualification, and whether there will be a per person limit. 

The Departments of Health and Human Services, Labor, and the Treasury will release more detailed guidance on at-home test reimbursement by Jan. 15. In the meantime you can get familiar with your health insurance provider’s reimbursement process by reading your plan documents or checking its website. You’ll almost certainly need to provide a receipt, so hold on to any digital or physical receipts for at-home tests from now on. 

Keep in mind that you can also use money from a health savings account or flexible savings account to directly purchase at-home COVID-19 tests. 

Work-mandated tests may not be reimbursable 

The Occupational Safety and Health Administration (OSHA) is currently blocked from enforcing the Biden administration’s vaccine-or-test mandate, which had an initial deadline of Jan. 4. But according to the White House, about 60% of U.S. businesses with 100 or more employees are moving ahead with plans to test workers weekly if they’re not vaccinated. 

OSHA doesn’t require employers to cover the costs of testing their unvaccinated employees (though it may be required by other laws, regulations, or collective bargaining agreements). That means employers can estimate testing costs and pass them on to employees. That’s what Delta Air Lines did — in November the company announced a $200 monthly health insurance surcharge for unvaccinated employees who are covered by its group health plan.

Costs of COVID-19 care

Thanks to a law passed by Congress early in the pandemic, private health insurers are required to cover the cost of COVID-19 tests administered at testing sites, doctor’s offices, and elsewhere. No copayments or cost sharing can be imposed for this type of testing. As for hospitalization or other care related to COVID-19, many individual insurance companies set their own rules about what’s covered and by how much.

It’s currently open enrollment season for buying health insurance through federal, state, and private insurance marketplaces. Americans who aren’t covered by workplace health insurance, Medicare, or Medicaid have until Jan. 15 to enroll in a plan for coverage that starts Feb. 1. 

You can compare different policies on Healthcare.gov — find out exactly which COVID-19 costs are covered by federal marketplace plans here — or through your state’s individual marketplace, if it has one. Plans and prices change every year. Even if you’re satisfied with your current plan, take some time to check out what else is being offered.

Image: Maskot / Getty