Coverage of COVID-19 At-Home Tests

On Monday, January 10, 2022, the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and Treasury released a joint Frequently Asked Questions document (“FAQs”) providing guidance surrounding President Biden’s order that private insurers and group health plans cover the costs of at-home over-the-counter (“OTC”) COVID-19 diagnostic tests. The FAQs address issues surrounding the types and number of tests insurers and plans must cover and how insurers and plans will directly pay or reimburse individuals for the tests.

Beginning January 15, 2022, insurance companies and group health plans will be required to cover the cost of OTC COVID-19 tests that are purchased on or after such date and included on the list of approved FDA tests. This requirement will enable individuals to purchase tests both online or in pharmacies or stores, and either have the costs paid for upfront or have them reimbursed through an insurer or group health plan. Though not required, the FAQ urges “direct coverage” of these tests, where insurers and plans develop a network of locations and online options that allow the individual to purchase tests without any costs at the point of sale.

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