Health plans begin coverage for at-home COVID tests in Minnesota

Minnesota health insurers are beginning to cover the cost of at-home COVID-19 tests, but state officials advise that consumers should contact health plans first to understand how to access the new benefits.

The federal requirement applies to private insurers, including all employer-sponsored group health plans, as well as individual policies from those carriers. Different guidelines apply, however, to coverage through the government-funded Medicare and Medicaid insurance programs.

The Biden Administration announced last week that private health insurers would be required to cover at-home COVID-19 testing costs. Insurers will pay up to $12 per individual test, or $24 for a package that contains two tests, and provide coverage for up to eight tests per person per month, according to an announcement Tuesday from the Minnesota Department of Commerce.

"The new rules apply to people who have private health insurance," said Julia Dreier, an assistant commissioner with the Minnesota Department of Commerce. "The best thing for people to do — because there are gaps — is for people to just call their insurance company to confirm and see what information they have available."

The administration is requiring coverage for at-home tests purchased over-the-counter on or after Jan. 15. Health plans have the option of reimbursing consumers for tests purchased at earlier dates, but they're not required to do so.

A frequently-asked-questions document from the federal government is a key resource for questions about the new testing benefit, which kicked in Saturday, the commerce department said.

The program is not open to the roughly 500,000 Minnesotans covered through the original Medicare program, although the federal government is pointing those seniors to other testing options.

About 500,000 Minnesotans obtain Medicare benefits through Medicare Advantage health plans, which "may offer coverage and payment for at-home over-the-counter COVID-19 tests," the federal government states in the FAQ document. "Consumers covered by Medicare Advantage should check with their plan."

To get free tests immediately — as opposed to getting reimbursed later for out-of-pocket costs — some consumers will have the option of visiting certain pharmacies or retailers that have been designated as preferred or network providers by their health plan. In those cases, consumers might need to visit the pharmacy counter to avoid out-of-pocket costs, according to the Minnesota Council of Health Plans.

"If they buy at the front of the store, it would typically be out-of-pocket and they could then submit to insurance for reimbursement," the trade group said in a statement. "Please keep in mind, though, that there may be limits on what that reimbursement is and will depend on whether they're within the amount of allotted tests covered per month."

To learn details, people enrolled in health plan coverage should look for member services contact information on the back of their insurance cards. The commerce department says consumers should ask their insurer if their health plan has a "direct coverage" option so they can get at-home tests for free at the point of sale.

"If you pay for at-home tests out of your own pocket, you will need to find out from your health plan how to submit to get those costs reimbursed," the state agency said in a news release. "Your health plan may require you to submit receipts for reimbursement if you pay for the tests out-of-pocket."

Consumers also might need to submit a reimbursement form.

"Your health plan may still be in the process of establishing how you can obtain reimbursement or direct coverage, but both options are required for health plans," the state's commerce department said.

COVID-19 tests continue to be offered through state-run testing centers, clinics and pharmacies across Minnesota. The Minnesota Department of Health also offers free at-home PCR tests by mail in collaboration with Vault Medical Services. Find a testing site and more info at mn.gov/covid19.