Starting Jan. 15, you can get certain at-home coronavirus tests for free — or get reimbursed if you pay upfront — so long as you have private health insurance. And next week, regardless of your insurance status, you will be able to order free at-home COVID-19 tests to be delivered directly to your doorstep.
President Joe Biden unveiled the new at-home testing programs in early December as part of his administration’s winter COVID-19 agenda, but the White House was tight-lipped about the details for more than a month.
This week, the Biden administration filled in some of the blanks. On Monday, the White House outlined specifics about a new federal program that requires private health insurance companies to cover at-home coronavirus testing kits. And on Thursday, the president shared a timeline for the release of a new government website that you can use to order free tests.
Here’s what you need to know about the two new testing programs.
How to get free at-home COVID-19 tests through your health insurance
Health insurance companies will be required to pay for certain at-home coronavirus tests, either by covering them upfront at no cost to you or by reimbursing the eligible tests that you paid for out-of-pocket.
“Beginning January 15, 2022, individuals covered by a health insurance plan who purchase an FDA-approved, over-the-counter COVID-19 diagnostic test will be able to have those tests covered by their insurance,” the White House tweeted.
“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated. Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people,” CMS Administrator Chiquita Brooks-LaSure said in a statement Monday.
While this program was developed to make testing easier and more affordable amid the surging winter case counts, not all tests are covered and not everyone is eligible for the program.
Know these five key points to ensure your at-home COVID-19 tests are covered.
You must have private health insurance.
Perhaps the largest qualifier to get your at-home tests for free — or at least get it reimbursed — is private health insurance.
According to the CMS, if you have Medicare or are uninsured, you won’t be eligible for this program. Some Medicare Advantage plans may offer coverage for at-home tests, and the CMS recommends reaching out directly to your insurer for details.
State Medicaid and Children’s Health Insurance Program (CHIP) members are already eligible for free at-home tests through the American Rescue Plan, but they don’t qualify for free (or reimbursed) COVID-19 testing through this new program.
Up to 8 FDA-approved tests per month are covered.
Your insurance provider is required to cover the costs of up to eight tests per month, per insured individual. You can get eight separate tests per spouse, child or other dependent who’s covered on your private insurance plan.
“That means a family of four can get 32 tests per month for free,” the CMS says.
There are no limits to the number of covered tests if they’re requested by a doctor or other health care provider, or if they are needed due to an underlying medical condition.
The tests must be approved by the Food and Drug Administration (FDA). The FDA has compiled a list of 43 approved at-home COVID-19 tests.
The reimbursement max is $12 per test.
The Biden administration aims to incentivize insurers to cover the cost of certain at-home tests upfront, at the point of sale, so that you’re not fronting any money whatsoever, according to the HHS. Unfortunately, insurance companies haven’t yet released details on how upfront coverage will work. (More on this below.)
But insurers are still required to reimburse you up to $12 per FDA-approved test if you pay out of pocket, even if your insurance provider prefers a certain pharmacy or type of test.
“For example, if an individual has a plan that offers direct coverage through their preferred pharmacy but that individual instead purchases tests through an online retailer, the plan is still required to reimburse them up to $12 per individual test,” the HHS says.
That also means, for instance, if you get health insurance through Aetna, an insurance provider owned by CVS, the company can’t force you to purchase tests offered only through CVS pharmacies.
Additionally, over-the-counter testing kits usually come in packs of two or more. The CMS website clarifies that a two-pack kit would be considered two separately reimbursable tests, for up to $12 apiece.
That said, pay close attention to the price-per-test when you’re shopping around. At-home tests are hard to come by in stores and at online retailers. On sites like Amazon, for example, vendors sometimes hike prices up when supply is low. As a result, the per-test cost can easily exceed $12 in certain cases.
You’re still free to buy them if the price exceeds $12 per test, but know that you won’t get a full reimbursement.
However, there is an exception: If your insurer does not set up a program that allows you to get tests through preferred pharmacies or retailers at no upfront cost to you, then it will be required to pay the full amount of the test, even if the cost exceeds $12.
“For example, if an individual buys a two-pack for $34, and the plan or insurer has not set up a system to cover costs upfront,” the CMS says, “then the plan or insurer would have to reimburse the $34 instead of $24”
Tests purchased before Jan. 15 might not be covered.
The new federal rules require health insurance companies to cover at-home COVID-19 tests purchased only on or after Saturday, Jan. 15.
However, insurers can cover at-home tests purchased before then if they choose to. If you have receipts for at-home COVID-19 tests you’ve already purchased, you should reach out directly to your insurance provider to see if they’ll cover the costs.
“Some states may have existing requirements related to coverage of at-home over-the-counter COVID-19 tests,” the CMS says.
Insurance companies will create their own reimbursement and coverage rules.
Health insurance companies are currently scrambling to implement the new rules announced by the White House.
The federal rules incentivize insurance companies to offer at-home tests at no upfront costs to you by allowing them to partner with preferred pharmacies and retailers. Theoretically, this means that if you go to your insurer’s preferred drugstore and find an at-home test that’s covered, you’ll be able to show your insurance card and get the test for no charge. In addition, each insurer will also be required to set up their own reimbursement process for tests that people pay for out of pocket.
“Health insurance providers will work as quickly as possible to implement this guidance in ways that limit consumer confusion and challenges,” Matt Eyles, president and CEO of America’s Health Insurance Plans, said in a statement. “While there will likely be some hiccups in early days, we will work with the Administration to swiftly address issues as they arise.”
This approach may result in each insurance company creating its own reimbursement and coverage requirements. Be sure to check in directly with your own health insurance provider for details.
Major health insurance companies have not yet released details publicly. Money reached out to several of the largest providers, including Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthcare for more information.
The Blue Cross Blue Shield Association (BCBSA) and Aetna responded, but they did not share details of how they plan to implement the new program.
“We appreciate the administration’s efforts to address this challenge,” BCBSA president and CEO Kim Keck said in a statement shared with Money on Tuesday. “That being said, we are concerned that the policy does not solve for the limited supply of tests in the country and could cause additional consumer friction as insurers stand up a program in just four days’ time.”
How to get free COVID-19 tests shipped directly to you
The second major free at-home testing program will include free shipment directly to your door. However, details are much thinner on this program. Here’s what we do know so far.
The White House will distribute 1 billion at-home COVID-19 tests for free.
Initially, President Biden announced that the home-delivery testing program would provide 500 million free tests. At a coronavirus update address Thursday, the president said he’s going to double that figure.
“In addition to the half-a-billion tests in the process of being acquired,” Biden said Thursday morning, “today, I’m directing my team to procure an additional 500 million more tests for distribution for free. That’s a billion tests in total.”
So far, the White House says it has procured approximately 380 million at-home tests.
You will have to order free tests on a government website.
To get free at-home COVID-19 tests from the billion stockpile that the government is amassing, you’ll need to use a forthcoming website to reserve and order them.
The White House has been hesitant to announce exactly when the new website is going live. Press Secretary Jen Psaki has said over the past weeks that the administration will release the website once the White House has at least a portion of the tests in hand and ready to ship.
On Thursday, the president narrowed down that window to some time during the week of Jan. 16.
“We’re on track to roll out a website next week where you can order free tests shipped to your home,” Biden said.
You won’t need health insurance.
While the other free coronavirus testing program requires you to have private health insurance to qualify, you will not need insurance to order free tests through the forthcoming government website.
White House officials have repeatedly said the delivery program will be available to “all Americans” at no cost.
Other ways to get free COVID-19 tests
Theoretically, once these programs are in full effect, getting free at-home COVID-19 tests should be as easy as popping into a local convenience store to pick them up or ordering a few from the government’s website.
But both programs face significant logistics and supply hurdles.
At-home coronavirus tests are already difficult to come by either in store or online. And while the Biden administration is contracting with several manufacturers to produce the one billion tests that it plans to distribute, it won’t procure all the tests at once. Shipments will come in waves, officials have said. That may result in stocking issues. If you do order them, it’s unclear how long delivery — which will be provided by the USPS — will take.
So what if you have symptoms and don’t have days to wait for at-home tests to restock or ship? You still have free options. But know that they will require you to go into public.
You can currently get tested for free in person at more than 10,000 pharmacies across the country, according to the CMS.
FEMA’s free “surge testing sites” are popping up in states that are hard-hit by the Omicron variant.
Many libraries and other community centers have also been distributing state stockpiles of at-home COVID-19 tests for free.
In his COVID-19 address, Biden pleaded with Americans to get vaccinated, get tested and wear masks. To help with that last request, he teased another new program that will cover the cost of masks.
“Next week,” Biden said Thursday, “we’ll announce how we’re making high-quality masks available to the American people for free.”
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