OTC COVID-19 tests available-Bukaty-Hubsopt-Winter-2022

    OTC COVID-19 tests available at no cost for most consumers

    Authored by Bukaty Companies on January 31, 2022

    In response to the Supreme Court ruling they do not have the authority to enforce mandatory vaccination and testing requirements, , OHSA has withdrawn the ETS. 

    The Department of Labor released a set of frequently asked questions addressing reimbursement for over-the-counter (OTC) COVID-19, FDA-approved diagnostic tests purchased by individuals with private insurance. Effective January 15, 2022, and through the remainder of the public health emergency, OTC COVID-19 tests can be reimbursed through a health plan.

    Health plans are allowed to limit the number and frequency of tests covered without cost sharing per participant to no less than eight tests per 30-day period. Health plans cannot limit COVID-19 tests ordered by health care providers.

    The DOL guidance allows for reimbursement of COVID-19 tests after purchase, but incentivizes health plans to provide tests without requiring consumers to pay upfront.
    Health plans that implement network pharmacies and direct-shipping programs that eliminate out-of-pocket costs can limit reimbursement of tests from out-of-network providers and online retailers to $12.

    Carrier-specific purchase policies can be found under our Carrier Notices.