Does Health Insurance Cover At-Home COVID Tests?

Since January 2022, health insurance plans have been required to cover the cost of at-home rapid tests for COVID-19. This applies to Medicare, Medicaid, and private insurers. Up to eight tests per 30-day period are covered.

This requirement will continue as long as the COVID public health emergency lasts. This declaration has been renewed every 90 days and is currently due to continue until at least January 11, 2023.

Once the declaration expires, at-home test coverage will likely vary by insurer. For example, it's expected that Medicare won't continue to pay for over-the-counter at-home tests, but testing in a doctor's office may still be covered.

This article will describe which health plans are subject to the coverage requirements and the types of at-home COVID tests that are available.

Does Health Insurance Cover At-Home COVID Test Kits?

In general, since January 15, 2022, most types of health insurance do cover at-home COVID test kits. This is expected to continue to be the case through at least mid-January 2023.

The rules require health plans to cover up to eight tests per month for each person enrolled in the plan, without a need for a prescription or doctor's order, and regardless of whether the person is symptomatic.

Due to legislation enacted early in the pandemic, most U.S. health insurance plans were already required to cover the cost of COVID testing for a person who was symptomatic or who had been exposed to someone who had tested positive for COVID, and at-home tests were covered in those circumstances if they were prescribed by a doctor.

Prior to January 15, 2022, the coverage requirement did include at-home COVID testing, but only if the at-home COVID test was “ordered by an attending healthcare provider who has determined that the test is medically appropriate for the individual.” Fortunately for people who want to routinely test themselves and their family members, that restriction was removed as of January 15, 2022.

The guidelines ensure that health plans cover the cost of COVID tests regardless of any other factors; a person does not have to be symptomatic or under a doctor's care, and can simply obtain the tests over the counter at a pharmacy.

This requirement is applicable until the end of the COVID public health emergency period. The emergency period has been extended several times in 90-day increments, and is currently scheduled to continue through January 11, 2023.

The Biden administration has said that states will be notified at least 60 days before the public health emergency ends. As of late November 2022, that notice had not yet been given, so the emergency declaration should be extended at least once more.

What Should Consumers Expect Under the Test Coverage Regulations?

Since January 15, 2022, people with employer-sponsored or self-purchased health plans (including grandmothered and grandfathered plans) have been able to obtain at-home COVID tests for free.

The Biden administration encouraged and incentivized insurers to establish arrangements with local pharmacies that allow people to pick up the tests without having to pay anything at all. But there's also an option for people to pay out-of-pocket for the cost of the test and then submit the receipt to their insurer for reimbursement.

If the health plan has a network of pharmacies where you can pick up tests for free and you decide to buy a test elsewhere, you can still submit your receipt to your health plan for reimbursement. But the plan is only required to reimburse up to $12 per test in that case (or the full cost of the test, if it's less than $12). Note that $12 is per test, so if you buy a box that contains two tests, as is commonly the case, your insurer would reimburse up to $24 for the box.

Insurers and health plans had the option to reimburse enrollees for tests purchased prior to January 15, 2022, but are not required to do so.

Do All Health Plans Cover the Cost of At-Home COVID Tests?

Most health plans in the U.S. are subject to the regulations that require them to cover the cost of at-home COVID tests. This includes employer-sponsored health plans as well as individual/family health plans that people purchase themselves (including grandmothered and grandfathered plans). Medicaid and CHIP plans are also required to comply with the new regulations.

Initially, Medicare was not included in the new regulations. But within a few months, the government added at-home COVID test coverage to Medicare as well. This began in April 2022, and continues through the end of the public health emergency. Beneficiaries with Medicare Part B can get up to eight over-the-counter tests per month, just like people with other types of health insurance.

Health plans that aren't considered health insurance, such as health care sharing ministry plans, are not subject to the federal COVID test coverage regulations and do not have to cover the cost of at-home COVID tests. Neither do short-term health insurance plans or excepted benefits such as fixed indemnity plans.

How Much Do At-Home COVID Test Kits Cost?

The price of at-home COVID test kits depends on whether it’s a rapid at-home antigen COVID test (with results in minutes) or a test kit that you use to collect saliva or a nasal sample at home and then mail to a lab for analysis. If you’re mailing in a sample, it will be a polymerase chain reaction (PCR) test, also known as a molecular test.

There are pros and cons to both approaches. PCR tests are more sensitive and less likely to give you a false negative result (in which you do have a COVID-19 infection but the test shows negative), although the timing of the test is important. Rapid antigen tests give you results in minutes, without having to wait for a lab to process the sample.

Single tests can be purchased for as little as $10, and two-pack test kits start at about $14, although the same kits can be more expensive depending on the store. As noted above, the federal guidance requires health plans to reimburse members up to $12 per test (up to $24 for a two-pack), which should cover the cost of most rapid antigen tests.

And again, health plans are incentivized to establish arrangements with pharmacies to allow members to simply show their insurance card and be able to obtain tests for free, without having to go through the reimbursement process. So you should check with your insurer to see if there are local pharmacies where you can do this, allowing you to skip the reimbursement process altogether.

Numerous rapid antigen tests have been granted emergency use authorization by the Food and Drug Administration (FDA), and many of them can be used for at-home screening.

If you’re purchasing an at-home PCR test—the kind that involves mailing your saliva sample to a lab for analysis—the price can be upwards of $100.

Should You Use FSA or HSA Funds to Buy At-Home COVID Tests?

If you have a medical flexible spending account (FSA) or a health savings account (HSA), you can use the money in the account to purchase at-home COVID tests. This means you’ll be using pretax money to buy the test kits, and this option has been available ever since at-home COVID tests came on the market.

However, you should not use HSA or FSA funds to buy at-home COVID tests if you're enrolled in a health plan that will cover the cost of at-home COVID tests. FSA and HSA funds can only be used to pay for medical expenses that are not reimbursed by your health plan. So if you use FSA or HSA funds to buy the test kit, you would not be able to also submit the receipt for reimbursement by your health plan.

HSA funds do not expire, so it's possible that you might still have money in an HSA even if you no longer have HSA-compliant health insurance. For example, you may have opted for something like a health care sharing ministry plan, which is not subject to the coverage mandate for at-home COVID tests. In that case, you can use your HSA funds to purchase at-home COVID tests if you choose to do so.

Summary

Free in-person COVID testing is readily available in most areas of the country. But if you prefer to take a test in your own home, there are COVID tests available for in-home use.

Since January 15, 2022, most health insurance plans in the U.S. have covered the cost of rapid at-home COVID tests. Up to eight at-home COVID tests must be covered for each plan member each month, and this regulation remains in effect for the duration of the COVID public health emergency period.

Insurers can establish agreements with pharmacies so that members can pick up tests without having to pay anything, or the health plan can reimburse members for the cost of a test.

A Word From Verywell

At-home COVID tests have made it easy and convenient for people to test themselves and their family for COVID. These test kits used to be in short supply on store shelves and fairly expensive, especially if a household needed to test multiple people at one time.

Thankfully, there is no longer a supply shortage. And the fact that health plans now cover the cost of at-home COVID tests means that there is also no longer a financial obstacle for most people. Increased access to free at-home COVID testing can provide another layer of security both before and after potential exposure to COVID. These tests can make it easier to meet in person with colleagues, classmates, loved ones, and the general public.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.