Beginning January 15, 2022, both health insurance companies and self-funded group health plans must cover over-the-counter (OTC) COVID-19 tests for members at no charge. The news was announced by the the Departments of Labor, Treasury and Health and Human Services on January 10 as part of the CARES Act.
Important details:
The free tests will continue through the end of the public health emergency.
The requirement currently applies to individual plans, both Marketplace and non-Marketplace, but does not apply to Medicare and Medicaid.
Self-funded group plans are required to cover the free tests.
Only FDA-approved tests with “OTC” listed in the attributes column are eligible for reimbursement. Click here for the full list. No doctors prescription is needed.
The limit for free tests varies depending on the insurance comany and could be as high as 8 per month for each family member. Check with your insurance company for details.
Reimbursement applies to OTC tests only. Tests that must be mailed to a lab for results aren’t covered, and tests must be for personal use only. Tests used for return-to-work testing or work-related testing required by an employer are not covered.
Some insurance companies may only require that a member present their ID card at a preferred pharmacy to receive a free test. Others will require that a member download a COVID-19 OTC At-Home Testing Reimbursement Form from their insurer, fill it out, and send it back with the original receipt and the UPC code from their test box.
For more information, check with your insurance company.