News & Insights

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

Written by Bukaty Companies | 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Court ruling they do not have the authority to enforce mandatory vaccination and testing requirements, , OHSA has withdrawn the ETS.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.