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Here's what to know about insurance reimbursement for at-home COVID-19 tests starting Saturday

At home covid test
Posted at 1:59 PM, Jan 14, 2022
and last updated 2022-01-14 18:33:31-05

(WXYZ) — Beginning Saturday, health insurance companies will have to pay for members' at-home COVID-19 tests.

The mandate from President Joe Biden's administration is designed to make it free across the board for everyone to get all tests, especially amid the surge of the omicron variant.

The home tests are in short supply, and it does not cover people on Medicare.

This unfunded mandate will cost insurance companies in Michigan billions of dollars, and it could be challenged. On Thursday, the U.S. Supreme Court blocked the Biden vaccine mandate for employers.

Just about everywhere you look, the shelves are empty where at-home COVID-19 test once were.

"We bought two. We didn't want to hoard - I think that's an issue right now. I think people are just buying everything off," one person said.

The Biden administration said the at-home tests are a gamechanger.

"We've already seen the strain in our hospital system. And I know part of the challenges and people in some parts of the country have had a hard time finding the tests," U.S. Surgeon General Dr. Vivek Murthy said.

The mandate for insurers to reimburse people was announced in December, and on Monday, the requirements were issued for companies. They must pay for up to eight tests a month for each person covered. That means a family of four could have 32 tests per month.

An unlimited number when ordered by a doctor or member with underlying health conditions. Insurance companies are now scrambling for Saturday.

"As you can imagine, this will be a fluid situation. So where we land for Saturday might not be where we land next week or the week after," Dr. Charley Bloom, the chief medical officer for HAP said.

HAP is Michigan's third-largest commercial healthcare insurance company. They have 430,000 members and said the unfunded mandate could cost them about $250 million this year. For self-insured employers who team up with HAP, it could be another $200 million.

Blue Cross Blue Shield, the largest in Michigan, said in a statement, "Throughout the pandemic, Blue Cross has covered over 5.5 million COVID tests, at a cost exceeding $430 million," and "We're currently reviewing how best to comply with it, as we do with all federal mandates."

No one is talking about legal challenges to the mandate – yet.

"I am a bit surprised we haven't yet. I think employers and insurers are still processing and trying to understand the impact," Bloom said.

HAP is working to set up preferred providers, which are retailers who will have tests available free for members. Also, they're looking at a system for mail orders and a process for reimbursement when tests are bought by the member.

"Keep this in mind as well, the cost to an insurance company of somebody who gets sick with COVID-19, especially who's somebody who may get quite ill, is quite significant. Testing is a way that we can identify infection early and then limit the spread," Murthy said.

The Biden administration is buying a billion of these home tests. They will be able to mail them out to you for free in the weeks ahead.

Details on reimbursement of... by WXYZ-TV Channel 7 Detroit

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