With the Omicron COVID-19 variant emerging in the US and elsewhere, testing is critical to enabling work, school and entertainment activities to continue. With rapid test kits in short supply, however, some retailers are making them unaffordable by hooking customers. Now, the Biden administration has announced that test kits must be covered by private insurance, Wall Street Journal reported.
People covered by private health insurance can be reimbursed for up to eight exams per month per individual. To make things simpler, the White House is encouraging insurers to partner with retailers and pharmacies so people can get tested without paying upfront or filing a claim. Exams are available without a deductible, coinsurance or co-payment, so a family of four on the same health plan can be reimbursed for 32 exams a month, for example. For these programs, reimbursement would be limited to $12 per trial.
Today’s action further removes financial barriers and expands access to Covid-19 testing to millions of people.
The new policy does not apply to Medicare, which has more than 60 million seniors at higher risk of complications from COVID-19. However, Medicaid for low-income people already covers FDA-authorized COVID-19 home testing. The government also plans to make tens of millions of free tests available to uninsured Americans at health clinics and other locations, according to The New York Times newspaper.
Some insurers said the government was acting too late and had not addressed the shortage of home testing. However, a national association of coverage providers said the new plan “takes steps to mitigate the real risks of price manipulation, fraud and abuse”.
Having enough diagnostic tests will be key to slowing the Omicron wave that is starting to overwhelm healthcare systems in the US and elsewhere. It can help isolate infected people or receive treatment more quickly, reducing potential transmission and hospital workloads.
This will become even more important with the authorization of antiviral pills from Pfizer and Merck that can help high-risk patients with mild to moderate symptoms of COVID – provided they are diagnosed in time. “This policy will help millions of families pay for COVID tests that allow them to be in school, visit family members and live their lives,” said Sabrina Corlette of Georgetown University. WSJ.
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