Effective January 15, 2022, insurance companies and group health plans will be required to cover the cost of at-home, over-the-counter COVID-19 tests that have been authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA). With the new coverage of at-home tests, individuals no longer need a health care provider to administer or order the test for the cost to be covered. There are exceptions.
Health plans are required to cover up to eight at-home COVID-19 tests per month for each person enrolled in the plan, including at-home tests that are ordered online. Depending on the individual's plan, the at-home COVID-19 tests will either be free up front through insurance or reimbursed after purchase.
For COVID-19 tests ordered or administered by a health care provider, including at-home tests, there is typically no limit on the number of tests that must be covered.
The Centers for Medicare & Medicaid Services (CMS) released Frequently Asked Questions (FAQs) with additional information regarding the coverage of at-home COVID-19 tests. One of the questions addresses employer-mandated COVID-19 testing:
- My employer requires that I test myself multiple times per week and send them the results as a condition of employment. Can I get these tests reimbursed by insurance?
Plans are not required to provide coverage of testing (including an at-home over-the-counter COVID-19 test) that is for employment purposes.
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