Big Insurers Change Little About Coverage of At-Home COVID Tests

A little more than a month after the Biden administration directed private health plans to fully cover at-home COVID-19 tests, insurers now have additional clarity from regulators about how to operationalize that mandate. Still, the country’s largest insurers do not appear to have significantly changed their approaches for covering at-home COVID tests since mid-January — with some still requiring members to submit claims for reimbursement rather than setting up more consumer-friendly direct-coverage pathways.

A Jan. 10 guidance document issued by the administration stated that by Jan. 15, all private group and individual health plans had to start covering up to eight over-the-counter, at-home COVID-19 tests per month for each covered member without imposing cost sharing or utilization management requirements. Previously, pandemic relief legislation required insurers to cover only diagnostic tests that were processed by a lab and ordered by a health care professional.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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