How to get your At-Home Over-The-Counter COVID-19 Test for Free

How do I get a free at-home over-the-counter COVID-19 test?

Starting January 15, most people with a health plan can go online to purchase an at-home over-the-counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance. This applies whether you purchased your health plan on your own or whether you get health insurance through your job.

The test will either be free directly at the point of sale, if your health plan provides for direct coverage, or by reimbursement if you are charged for your test. Be sure to keep your receipt if you need to submit a claim to your insurance company for reimbursement. If your plan has set up a network of preferred providers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers outside that network. Insurance companies are required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12).

Will I have to pay for my test up front?

If you are charged for your test after January 15, keep your receipt and submit a claim to your insurance company for reimbursement.

How much will I be reimbursed for an at-home over-the-counter COVID-19 test if I purchase the test upfront and then submit a claim for reimbursement to my insurance company?

If you purchase an over-the-counter COVID-19 test from an online retailer and are charged for your test, keep your receipt and submit a claim to your insurance company for reimbursement. If your plan has not set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you will be reimbursed the amount of the cost of the test.

If your plan has set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers if you buy them outside of that network. Your plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Save your receipt(s) to submit to your plan for reimbursement at a rate of at least $12 per individual test (or the cost of the test, if less than $12).

Why would these companies be incentivized to cover the cost up front?

If a plan or insurer sets up a network of convenient options such as pharmacies or retailers, including online retailers, in which individuals on their plans can get their tests’ cost covered up front (at the point of sale), then it is permitted to limit the per test reimbursement amount for retailers outside of that network. Specifically, if a plan or insurer establishes this type of direct coverage option, then the plan or insurer is permitted to limit the reimbursement for tests purchased outside of their network to $12 per test (or the actual price of the test, if less). Many commercially available at-home tests run about $12 or less per test.

If the plan or insurer does not set up a process through which individuals can obtain test with no upfront costs, then the plan and insurer must reimburse in the full cost of the test, even if the test costs more than $12. For example, if an individual buys a two-pack for $34, and the plan or insurer has not set up a system to cover costs upfront, then the plan or insurer would have to reimburse the $34 instead of $24.

What if I already bought and paid for at-home over-the-counter COVID-19 tests? Can I still get reimbursement for those?

Plans and insurers are required to cover at-home over-the-counter COVID-19 tests purchased on or after January 15, 2022.

What if I buy more than one test at a time?

Your plan is required to provide reimbursement for 8 tests per month for each individual on the plan, regardless of whether the tests are bought all at once or at separate times throughout the month.

If your plan has set up a network of convenient options such as pharmacies and retailers, in which individuals can get their tests’ cost covered up front (at the point of sale) then the plan is permitted to limit the reimbursement for tests purchased outside of their network to $12 per test (or the actual price of the test, if less than $12). If more than one test is purchased or ordered at a time, such as a package with two tests in it, then the insurer would reimburse up to $12 for each of the tests purchased at that time.

If I pay up-front, how do I get reimbursed?

If you are charged for your test, keep your receipt and submit a claim to your health plan for reimbursement. You can find out directly from your plan how to submit reimbursement claims. They are not allowed to design their reimbursement process in a way that unduly delays your reimbursement. You will not need a prescription or a note from your provider.

How long will it take to receive my reimbursement from my plan?

Health plans are encouraged to provide prompt reimbursement for claims for at-home tests, and consumers can find out directly from their plan how their claims process works and ask questions about reimbursement timing.

My employer requires that I test myself multiple times per week and send them the results as a condition of employment. Can I get these tests reimbursed by insurance?

Plans are not required to provide coverage of testing (including an at-home over-the-counter COVID-19 test) that is for employment purposes.

Do state Medicaid and CHIP programs cover at-home COVID-19 tests?

In accordance with the American Rescue Plan, State Medicaid and CHIP programs are required to cover FDA-authorized at-home COVID-19 tests. People with Medicaid or CHIP coverage should contact their state Medicaid or CHIP agency for information regarding the specifics of coverage for at-home COVID-19 tests, as coverage rules may vary by state.