Updated White House COVID-19 Testing Guidelines for Private Health Insurance Coverage
Ever tried navigating the labyrinth of insurance claims? Well, hold onto your hats because the White House just spiced things up in the realm of at-home COVID-19 tests. Starting January 15, your health insurance provider is required to foot the bill for up to eight COVID-19 tests per month. But— and it’s a big but— insurers are playing by their own rules on how you’ll get reimbursed, which could turn the simple act of filing a claim into something akin to rocket science.
Under the new initiatives, insurers must cover costs from those FDA-approved swabs with a cap of $12 per test. Some insurers are skipping the hassle and teaming up with pharmacies and retail giants, allowing you to just waltz in, show your insurance card, and walk out with a test at no upfront cost. If you find yourself with an insurer who hasn’t set up this cozy deal, they’ll need to reimburse you fully, even if the test costs more than the $12 cap.
This week, big names like Aetna, Cigna, Humana, and UnitedHealthcare started to sketch out whether their members should save receipts for a rainy day or just grab tests off the shelf and stroll out with zero fuss. But let’s face it, some are dragging their heels about spilling the deets on their exact plans.
Coverage Process and Consumer Concerns
Trying to figure out some insurers’ plans is like deciphering hieroglyphs—complex and confusing. A select few want you to mail or fax—yes, fax in 2023—reimbursement forms along with receipts and, believe it or not, possibly the barcodes from your test kits.
While the Centers for Medicare and Medicaid Services (CMS) have toddled in to say, “Hey, make it snappy with those reimbursements,” nobody promised a rose garden. Red tape might still make an unwelcome appearance.
Remember, if you have private insurance, this is your circus. It’s different from the free home-delivery service via COVIDtests.gov, delivering four tests to every U.S. household regardless of insurance status.
How to Secure Insurance Coverage for COVID-19 Test Costs
Aetna
Aetna is doling out details bit by bit, like breadcrumbs. They’ve spun up an FAQ page where they mention that over-the-counter (OTC) tests usually fall under pharmacy benefits. So before you go on a wild goose chase, check your prescription benefits on your card and use Aetna’s pharmacy locator to maybe score some free tests. Bought your tests from a random shop? Get ready to file for reimbursement.
Anthem
Hold onto those receipts like your favorite childhood teddy bear because Anthem wants them if you’re claiming money back. All you need to do is trot over to your online Anthem account and file away.
Cigna
Hope you’ve got a printer because Cigna is old school with its COVID reimbursement ways. Print out their form, attach your grocery-sized receipt, and either mail it or send it via fax to their mystical lair (just kidding, it’s a regular office).
Humana
Humana’s not just asking for receipts; they want those UPC numbers too. Fill out their form, gather your proofs of purchase, and mail them to the address that’s probably on the back of your insurance card. They also have an online tool to sniff out in-network pharmacies, which might save you some upfront cash.
UnitedHealthcare
If you’re with UnitedHealthcare, you might just hit a jackpot at select pharmacies like Walmart, Sam’s Club, Rite Aid, and Bartell Drugs. Show off your UnitedHealthcare card with the OptumRx logo, and bingo—free tests! If you ventured outside their preferred network and bought a test, you’ll need to tackle their online or mail-in claim process.
As the dust settles on these new testing coverage rules, keeping tabs on the ever-evolving guidelines will help you stay ahead and maybe, just maybe, make claiming those tests a walk in the park. Keep those receipts handy, stay patient, and good luck navigating the wild world of insurance reimbursements!