This story has been updated.
As omicron marches across the country, Americans need affordable rapid covid tests badly. Some families say they’ve already spent hundreds of dollars on them and many hours trying to find them, with no luck, in pharmacies and from reliable online sellers. It’s an unsustainable situation.
There was a limited supply of rapid tests before omicron gained a foothold in the United States, then tests began to sell out everywhere once the variant arrived.
The Biden administration has announced a few measures in response to the crisis. It has called on private insurers to reimburse customers for home rapid test purchases. And it has promised to get 1 billion free tests into the hands of Americans across the country. (Even though the bulk of them may not be available for months.) Meanwhile, local and state governments are rolling out programs as well.
Rapid tests aren’t as consistently reliable as PCR tests, the results of which take at least a day, and often days, for a lab to return to patients. The huge increase in the use of rapid tests could worsen the information gap health officials already face on the true state of covid in the United States. But, still, rapid tests are the best option for quickly determining whether you have covid and should stay away from others.
“There’s already challenges with supply and demand, so right now, if you’re looking for a test, say, at an online retailer to get sent to your home, you’re going to probably have to look for a few different types of tests or be flexible in the type of test you’re willing to use and potentially look across different retailers to be able to find something,” said Lindsey Dawson, a policy expert on rapid testing at the Kaiser Family Foundation, “and then once you find it, you may have to wait over a week for delivery dates on many of these tests.”
Here are new ways that Americans can now access rapid tests.
Health insurers will begin reimbursing customers for rapid tests
Those on private insurance and group plans can start buying tests over the counter and get reimbursed for the cost of tests purchased out of pocket on or after Jan. 15.
Tests can be purchased online or in stores, but they will have to be tests authorized by the Food and Drug Administration, according to the guidance. Under the plan, insurance companies will be required to cover eight over-the-counter at-home tests (up to $12 per test or $24 for a box of two) per covered individual per month. This means a family of four, who are all on the same plan, would be eligible for up to 32 tests covered by their health plan per month. Plans are not required to provide testing if it’s for employment purposes. Importantly, tests typically come in a box of two, so consumers should keep that in mind when submitting reimbursements.
At the same time, the administration is asking insurers to partner with pharmacies and retailers so that people getting over-the-counter tests can get them for free directly at participating pharmacies and retailers it partners with rather than having to go through what could be an arduous process for submitting individual claims for reimbursement.
But for now, it’s unclear if insurance plans have forged those partnerships, and in some cases, whether they have given guidance to policy holders, meaning the rollout of this part of the administration’s plan to get the country tested could get messy.
Grid reached out to several of the biggest private insurance companies in the country, including Aetna, Blue Cross Blue Shield, Anthem, Cigna, Humana and United Healthcare to see whether they had any guidance for their policy holders on how to get reimbursed. Most of them had some form of guidance.
Anthem encouraged policy holders to save their receipts for over-the-counter tests as it finalizes its reimbursement process. Cigna asked policy holders to download and print a reimbursement form. Aetna told Grid three days before the policy was set to go into effect that it was still reviewing the administration’s guidance and would adjust its coverage policies “as appropriate.”
Blue Cross Blue Shield told Grid a few days before the policy went into effect: “We appreciate the administration’s efforts to address this challenge, including measures to protect against price gouging and abuse. That being said, we are concerned that the policy does not solve for the limited supply of tests in the country and could cause additional consumer friction as insurers stand up a program in just four days’ time. We will continue to partner with the administration and retailers to help make this work and advocate for policies that promote affordable and equitable access.”
But health experts say the reimbursement phase of the administration’s plan could be tricky for consumers — and given the country’s already limited test supply, the plan is still a work in progress.
“The Biden administration is not really prescribing how health plans set this process up, so you could see a huge amount of variation from plan to plan and insurance company to insurance company,” said Sabrina Corlette, a research professor, founder and co-director at Georgetown University’s Center on Health Insurance Reforms. She worries it could take weeks, if not months, for consumers to get reimbursed for individuals claims: “Quite frankly, I’m not sure the health plans have a huge incentive to educate their policy holders about this kind of benefit.”
What if you don’t have private health insurance?
If you are uninsured or on Medicaid, the reimbursement rules do not apply. Instead, the Department of Health and Human Services is in the process of setting aside up to 50 million at-home tests at community health centers and Medicaid-certified health clinics across the country, where the uninsured and Medicaid recipients can pick them up for free. HHS also set up more than 10,000 free community-based pharmacy testing sites around the country. The administration’s test website is also supposed to provide free tests to Americans who may be uninsured or on Medicaid, but there could be additional access issues when it comes to using the website if someone does not have a home address.
Having access to free tests if you are uninsured or on Medicaid will also largely be determined by where you live. For now, HHS has created a database where you can search for free community-based testing sites here.
Additionally, state Medicaid and the Children’s Health Insurance Program are already required to cover FDA-authorized at-home tests, and the administration is urging Medicaid and CHIP holders to contact their state agencies for information about the specifics of their coverage for at-home tests because coverage rules could vary depending on which state they live in.
Ordering tests online to get shipped to your home for free
On Tuesday, the White House unveiled covidtests.gov, a new website for people to order free tests to their homes. It was initially slated to launch on Wednesday, but users can start requesting tests a day earlier than planned. The White House said test orders would take seven to 12 days to ship after they are placed.
Tests will be limited to one order of four per residential address, and additional tests cannot be ordered regardless of how large a household is, the U.S. Postal Service said.
Tests in the continental United States will be sent through First Class mail, while shipments to Alaska, Hawaii and U.S. territories would be sent through Priority Mail, the White House said. The Postal Service will lead the effort and deliver the tests across country. The Postal Service plans to hire as many as 7,000 temporary workers to package and address the test kits at 43 fulfillment centers across the country, Mark Dimondstein, president of the American Postal Workers Union, recently told NPR.
The administration said it would address issues around equity by launching a hotline to help those who are unable to access the website and prioritize processing test orders to households with the “highest social vulnerability and in communities that have experienced a disproportionate share of COVID-19 cases and deaths, particularly during this omicron surge.” Additionally, the White House said it would work with national and local community-based organizations to help hard-hit and high-risk communities request tests.
The administration has started awarding contracts to obtain the first 500 million tests. On Friday, the White House said it awarded several contracts already and had more than 420 million tests under contract with more contracts to be awarded in the coming weeks.
Local governments are stepping in to fill the gap
In the meantime, some localities have been stepping in to distribute rapid antigen tests for free.
In New York City, the Department of Health has set up free rapid tests at express sites. In Washington, D.C., residents can pick up free antigen tests at libraries across the city by showing proof of residency. Chicago also offers some free tests, as does Houston, and there are also some locations in Los Angeles.
Many local school districts are starting to do so as well, and the Biden administration has a plan to send out 10 million rapid tests to schools.
The federal government also operates 18 free surge testing sites in New York, New Jersey, Pennsylvania, Nevada and Washington, D.C., and is slated to open 20 more sometime soon.
Check with your local officials or school administrators to see if your locality has a test distribution program.