Contact insurance coverage 6 tests, home COVID tests

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It is now more affordable for Americans to test themselves for COVID-19 at home. On January 15, the federal government began requiring insurance companies to cover the cost of home testing.

If you have private insurance or a group health plan, you can get coverage for up to eight tests per person per month. A family of four can cover up to 32 tests per month.

“It’s a good tool if you have symptoms or if you’re exposed to someone. To have it on hand,” said Marwa Bakr of Infinity Pharmacy in Milwaukee.

On Wednesday, cars were lined up for COVID-19 testing at Infinity Pharmacy’s drive-thru. The pharmacy received many calls asking if they had home tests in stock. When Contact 6 visited on Wednesday, the pharmacy had no inventory but was awaiting another delivery.

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The government is pushing insurers to set up networks of preferred pharmacies and retailers, so consumers can get their tests covered in advance, instead of keeping the receipt and submitting a claim later.

“The key is whether you’re going to get reimbursed after the fact or whether you’re going to get it covered over the counter at the pharmacy,” said Sarah Smith, director of public affairs for the Office of the Insurance Commission (OCI).

So how does obtaining insurance coverage work in practice?

Contact 6 reporter Jenna Sachs visited her insurer’s website and found her favorite retailer. Then she went to the store’s pharmacy on Wednesday to find out if the process would go smoothly.

Sachs found a handful of boxes left on a shelf and took them to the pharmacy counter, where she was told she was the “first person” to ask for coverage. Twenty minutes later, Sachs was approved for full coverage and left the store with four tests worth about $40 and an invoice showing she owed $0. Overall the process went well.

“Each swab can be reimbursed up to $12, that’s the requirement,” Smith said.

For consumers who cannot visit a pharmacy or preferred retailer, insurers post reimbursement forms on their websites. But while insurance coverage is one thing, access to home testing is another.

“They go very fast,” Bakr said. “Once I get my shipment, it doesn’t last a few hours and then it’s gone.”

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Contact 6 has hit stores again in search of at-home testing. Sachs visited four Milwaukee retailers and found tests on the shelves at each location, albeit sometimes in limited supply. Store employees told him that inventory remained tight.

Bakr says Infinity Pharmacy doesn’t shy away from calls to find out if it has at-home testing in stock. When the tests arrive, she says her staff are ready to handle insurance claims.

“I have a few clients who called me and said, ‘I checked with insurance and you’re in the network,'” Bakr said.

If an at-home test costs more than $12, the consumer may have to pay the difference, depending on their insurance plan. Tests purchased before January 15, 2022 are not eligible for reimbursement.

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