PHILADELPHIA (KYW Newsradio) — Beginning Saturday, health insurance companies will have to cover the costs of at-home COVID-19 tests.
But so far, insurers have not figured out how to make the payments.
Guidance from the Biden administration issued this week said insurers must cover up to eight tests through preferred pharmacies each month, per covered individual, without a prescription, and an unlimited number if they are ordered by a doctor.
The companies cannot apply deductibles, co-pays, or other cost control measures.
But the guidance did not specify whether coverage will be applied upfront so that consumers can simply walk out with tests at no charge, or whether customers have to file claims for reimbursement.
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A statement from Aetna and CVS said they are still studying the guidance.
An Independence Blue Cross spokesperson also had no definitive instructions, though she said customers are advised to begin saving their receipts on Saturday.
“We are working diligently to implement the Biden administration’s over-the-counter (OTC) testing program in the limited amount of time provided," the Independence Blue Cross statement said.
"However, we are concerned that the supply of tests may not be adequate to meet consumer demand. In the coming days, we will work with the administration to obtain additional implementation guidance. We will share additional information as implementation plans become clearer. Members should keep their receipts for OTC COVID-19 tests purchased on or after January 15.”
Even if insurers set up these preferred networks, they would still have to reimburse customers up to $12 each for tests purchased outside the network.
A statement from the Association of Health Insurance Providers said it understands the guidance will mitigate the risk of price-gouging, fraud, and abuse.
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“We recognize that the administration’s guidance takes steps to mitigate the real risks of price gouging, fraud, and abuse, which would limit access and reduce affordability for everyone," the statement said.
"Providers will work as quickly as possible to implement the guidance in ways that limit consumer confusion.”
But, the statement warned, “there will likely be some hiccups in early days.”