Minnesota health insurers are beginning to cover the cost of at-home COVID-19 testing, but state officials are advising consumers to contact health plans first to understand how to access the new benefits.
The federal requirement applies to private insurers, including all employer-sponsored group health insurance plans, as well as individual policies from these carriers. However, different guidelines apply to coverage under the government-funded Medicare and Medicaid insurance programs.
The Biden administration announced Last week that private health insurers would be required to cover the costs of home COVID-19 testing. Insurers will pay up to $12 per individual test, or $24 for a package containing two tests, and provide coverage for up to eight tests per person per month, depending on a announcement tuesday of the Minnesota Department of Commerce.
“The new rules apply to people who have private health insurance,” said Julia Dreier, assistant commissioner at the Minnesota Department of Commerce. “The best thing for people to do – because there are gaps – is they just call their insurance company to confirm and see what information they have.”
The administration requires coverage for at-home tests purchased over-the-counter on or after Jan. 15. Health plans have the option to reimburse consumers for tests purchased at earlier dates, but they are not required to do so.
A frequently asked questions document from the federal government is a key resource for questions about the new testing delivery, which began on Saturday, the Commerce Department said.
The program is not open to the approximately 500,000 Minnesotans covered by the original Medicare program, although the federal government is referring these seniors to other testing options.
About 500,000 Minnesotans obtain Medicare benefits through Medicare Advantage health plans, which “may provide coverage and payment for over-the-counter COVID-19 tests at home,” the federal government says in the FAQ document. “Consumers covered by Medicare Advantage should check with their plan.”
To get free tests right away — instead of being reimbursed for out-of-pocket costs later — some consumers will have the option of visiting certain pharmacies or retailers that have been designated as preferred or network providers by their health plan. In those cases, consumers might need to go to the pharmacy counter to avoid out-of-pocket charges, according to the Minnesota Council of Health Plans.
“If they buy at the front of the store, it would usually be out of pocket and then they could submit to insurance for reimbursement,” the trade group said in a statement. “Please keep in mind, however, that there may be limits to what this reimbursement is and will depend on whether they do not exceed the number of allocated tests covered per month.”
For more information, individuals enrolled in a health insurance plan should look for Member Services contact information on the back of their insurance card. The Commerce Department says consumers should ask their insurer if their health plan has a “direct coverage” option so they can get free home testing at the point of sale.
“If you are paying out of pocket for home testing, you will need to inquire with your health plan about how to submit for reimbursement of these costs,” the state agency said in a news release. “Your health plan may require you to submit receipts for reimbursement if you pay for the tests out of pocket.”
Consumers may also need to submit a refund form.
“Your health plan may still be working out how you can get reimbursement or direct coverage, but both options are required for health plans,” the state Department of Commerce said.
COVID-19 testing continues to be offered at state-run testing centers, clinics and pharmacies across Minnesota. The Minnesota Department of Health also offers free home PCR tests by mail in conjunction with Vault Medical Services. Find a test site and more information on mn.gov/covid19.