Many major insurance companies do not have consumer-friendly COVID-19 test coverage policies.
Major insurance companies are starting to comply with the Biden administration’s new COVID-19 home test coverage requirements, but some payers’ policies are more consumer-friendly than others, according to a new report. analysis from the Kaiser Family Foundation.
While some insurers, such as UnitedHealth Group, allow members to purchase rapid tests free of charge from in-network pharmacies or “preferred” retailers such as Walmart, others, including Cigna and Care First, require members to purchase tests with cash and mailed claims for reimbursement.
KFF studied the policies of 13 insurance companies, each covering more than 1 million people, and found that about half of them offer free direct coverage of home tests through pharmacies or retailers, while others require members to fill out paperwork for reimbursement. either through the website or by mail.
Of the five insurance companies that do not currently offer direct test coverage, four require members to request reimbursement using a mail-in form: Blue Cross Blue Shield of Michigan, Blue Shield of California, Care First, and Cigna.
Anthem does not have direct coverage, but members can apply online.
According to the analysis, Kaiser Permanente plans to offer a direct coverage option but also allows online reimbursement. Michigan-based Blue Cross Blue Shield said it is working to build a pharmacy network so members have “easier access” to free tests.
Blue Cross Blue Shield of North Carolina, Centene/Ambetter, Guidewell, Health Care Service Corporation, Humana, and UnitedHealth Group allow direct coverage either through network pharmacies or other retailers they partner with. Some of these plans, including Blue Cross Blue Shield of North Carolina and Humana, still require members to claim reimbursement for out-of-network tests in order to mail in applications.
“In some ways, this could be more difficult for consumers,” said Lindsey Dawson, KFF associate director and co-author of the analysis.
“It’s pretty volatile,” Dawson said. “People really need to understand what their own insurance company does and requires, and not look at what other people, their friends or their family might be doing.”
The Biden administration’s guidance, released last week, requires commercial plans to reimburse insurers for eight at-home COVID-19 tests per person per month. The policy went into effect Jan. 15, leaving some insurers struggling to find tests or retail partners, said Cecy Connolly, president and CEO of Alliance of Community Health Plans, which represents small nonprofit payers. The administration first announced the requirement last month.
Home tests are in high demand, she said, and the effort is complicated by a lack of available tests, and ACHP insurers have struggled to find pharmacies or retailers to partner with.
“In the meantime, we’re worried that people will get the impression that they have eight tests with their name on them at their local pharmacy,” Connolly said.
Dirk McMahon, president and chief executive officer of UnitedHealth Group, told shareholders during an earnings call on Wednesday that the insurance company has partnered with Walmart and Rite Aid to allow consumers to take home tests for free within four days of entry into force. by virtue of the mandate.
“We look forward to new partnerships in the coming days,” McMahon said. “Looking forward, we believe we have the necessary capabilities to deliver on our business priorities and meet our customers’ expectations.”
President Joe Biden has put more emphasis on rapid testing because of the omicron option. This week, the White House announced a separate event to send out four free home COVID-19 tests per household per month to anyone who orders through covidtests.gov. From next week, more than 400 million N95 masks will also be made available to people free of charge at pharmacies and other places.