COVID-19 has accelerated use of remote access to health services, particularly, telehealth. Recent decisions at federal and state levels mandate no-cost insurance coverage to at-home tests for COVID-19 and STI screening. Below are highlights, some details, and limitations.
National: COVID-19 Over-the-Counter Diagnostic Tests
Building on legislation enacted in 2020 mandating no-cost coverage of COVID-19 tests, and the emergence of at-home tests in mid-2021, HHS has issued guidance for insurance plans to make at-home COVID-19 tests available, free of charge. Tests do not require a clinician's order and can be secured via various venues. The rule goes into force January 15, 2022. Insurers can limit the number of tests requested to eight (8) per month and allows for enforcement against suspected fraud and abuse.
Read the press release, the consumer-friendly FAQs: How to get your At-Home Over-The-Counter COVID-19 Test for Free and the more detailed FAQs About Affordable Care Act Implementation Part 51, Families First Coronavirus Response Act And Coronavirus Aid, Relief, And Economic Security Act Implementation.
California: At-Home STI Tests
As of January 1, 2022, insurance plans are required to cover at-home sexually transmitted infection (STI) tests. However, the KHS (Kaiser Health News) article With Sexually Transmitted Infections Off the Charts, California Pushes At-Home Tests highlights implementation delays. The state's Medicaid program (Medi-Cal) has yet to set up billing codes and STI at-home tests have yet to be approved by federal regulators, which means that labs may decline to process test kits.