With the COVID-19 Omicron variant surging in the US and elsewhere, testing is key to allowing work, school and entertainment activities to continue. With rapid test kits in short supply, though, some retailers are making them unaffordable by gouging customers. Now, the Biden administration has announced that testing kits must be covered by private insurance, The Wall Street Journal has reported.
People covered by private health insurance can be reimbursed for up to eight tests a month per individual. To make things simpler, the White House is encouraging insurers to partner with retailers and pharmacies so people can pick up tests without paying up front or submitting a claim. The tests are available without deductibles, coinsurance or co-payment, so a family of four on the same health plan could be reimbursed for 32 tests a month, for instance. For such programs, reimbursement would be limited to $12 per test.
Today’s action further removes financial barriers and expands access to Covid-19 tests for millions of people.
The new policy doesn't apply to Medicare, which counts more than 60 million seniors at higher risk for COVID-19 complications. However, Medicaid for low income folks already covers at-home COVID-19 tests authorized by the FDA. The administration also plans to make tens of millions of free tests available to uninsured Americans at health clinics and other sites, according to The New York Times.
Some insurers said that the administration is acting too late and that it didn't address the shortage of at-home tests. However, one national association of coverage providers said that the new plan "takes steps to mitigate the real risks of price gouging, fraud and abuse."
Having enough diagnostic tests will be key to slowing down the Omicron wave that is starting to overwhelm health systems in the US and elsewhere. It can help get infected people isolated or into treatment more quickly, reducing potential transmission and hospital workloads.
That will become even more important given authorization for antiviral pills from Pfizer and Merck that can help high-risk patients with mild to moderate COVID symptoms — provided they're diagnosed in time. "This policy will help millions of families afford COVID tests that allow them to be in school, visit family members and live their lives," Georgetown University's Sabrina Corlette told the WSJ.