Health Insurers Forced To Cover Rapid COVID-19 Tests Even Though They Don't Know How
While the rule is set to go into effect this weekend, companies are scrambling to figure out how to cover or reimburse people for the tests.

On Monday, the Biden administration announced that it would require private insurers to cover the cost of at-home COVID-19 rapid tests. The mandate is set to go into effect tomorrow. While it has been criticized for its likelihood to lead to shortages and higher costs, health insurers are running into another problem: They don't know how they'll follow the new rule.
According to New York Times reporter Sarah Kliff, health insurers are struggling to develop some way of implementing the new rule. Health insurance systems are set up to process medical billing codes that correspond to particular services or procedures; they are not equipped to cover or reimburse retail purchases. As Kliff reports, the best advice that insurers can offer most customers is to simply save their receipts, and the boxes the tests came in, to file for reimbursement at an unspecified later date. As one insurance broker characterized it, "There will be some people who buy them, and then have a six-month nightmare trying to get reimbursed."
All told, some insurance companies say that it will take weeks before they are completely ready.
The insurers' response underscores the clearly disorganized way in which the rule was conceived. The Biden administration is offering a solution that does not have a straightforward method of implementation. Coupled with widespread vaccination, easy access to rapid tests is a critical component of ending the COVID-19 pandemic. This is as true today as it was over a year ago, as Americans waited for the Food and Drug Administration (FDA) to finally approve a rapid test for at-home use—an approval that finally came more than eight months into the pandemic, yet still required people to get a prescription.
Lack of FDA approval is the primary obstacle standing in the way of readily available rapid tests on store shelves. Plenty of tests—including some made by American companies!—are available in Europe, but remain unavailable to Americans because of the slow pace of bureaucracy. The Biden administration's attempts at playing catch-up have consistently missed the mark. The solution is simple: Loosen the FDA approval process, and stand aside.
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You beat me to it Chumby.
Whatever.
… easy access to rapid tests is a critical component of ending the COVID-19 pandemic.
Never give up, never surrender.
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I don't want any covid home test kits. Can I substitute and get my insurance company to reimburse me for a "DeSantis 2024" ballcap?
Buy it. File for reimbursement. Resell on ebay.
Move along. nothing to see here. just more legislation by administrative rule. par for the course.
What? Biden doesn't actually know how health insurance works?
SHOCKING
It is important to note that under a free market you would just buy the test and NOT get reimbursed. Also, most people would buy tests that are crap if the FDA didn't get involved because the way the system works now the free market is always trying to screw you out of something.
Companies hate their customers.
You.
Are.
STILL.
Full.
Of.
Shit.
Bootlicker.
Had to look up top. I automatically assumed it was the "science editor" Bailey flogging the dead horse that is testing our way out of the pandemic.
He's ghostwriting for the intern. Or at least breathing heavily over the shoulder.
Of course, all this ignores the simple fact that the only reason to get tested is to present "papers" on demand to satisfy insatiable fascist rulers.
I am still waiting for the one actual journalist left in the country to tell us which members of congress and Biden's family own how much stock in which companies that have the federal government mandate their products.
Nobody accepts these tests as official. The only use for these is for hypochondriacs to constantly test themselves.
Entirely untrue. They're quite useful for government officials who need to look like they're doing something and for average citizens who, whether they want to or not, need to look like they're doing something in order to walk into a school, courthouse, commercial airliner, or cruise ship.
Now the uninsured will not be able to afford to pay for tests when the price jumps to 250 or more each.
Yup. It is like we need insurance to pay for replacement shoelaces.
Or if you're having trouble with your in-laws (ICD-10 Z63.1) or walking around looking like a hot mess (ICD-10 R46.1).
"Plenty of tests—including some made by American companies!—are available in Europe."
Interesting...mine came with a Certificate of Authenticity that it was made in China. Certainly, with a labor shortage, we should be able to find people willing to work to manufacture tests in the good old United States.
My point is simple. Healthcare companies are always one step ahead of the Government. Every one of them have already "risk assessed" every aspect of Covid. They know exactly what to do, how to defer blame if it doesn't go right, and what to push back on. I have a little violin around here someplace.
Get a bigger violin for all the rate- and tax-payers who will get stuck paying for this shit.
Really considering what my options are to not pay these days...
One hopes that the health insurance company’s lawyers are preparing lawsuits against this government dictat.
Why? They'll just raise premiums to cover any additional costs and continue on as usual
Many health plans offer "OTC" cards that allow for the purchase of over-the-counter drugs and health-related products. Why not allow these tests to be purchased with those cards?
The tests are already covered under those, but those flexible spending accounts (FSAs) which are separate from insurance (different company, separate payroll election/deduction)
Health insurers basically have a government forced business thanks to Obamacare. This is what they wanted, well, they are getting it.
My kid bought us a 2- pack for $24. I reimbursed him for it out of my checking account. I would have used my Health savings account but it was only $24 and the accounting would be a pain. All the money I saved by spending 10 days in quarantine at home still let me come out ahead.
"All the money I saved by spending 10 days in quarantine..."
You know it's really easy to get a job now.
Health insurance systems are set up to process medical billing codes that correspond to particular services or procedures;
Bullhonky! There are medical codes around the treatment for all kinds of injuries and medical maladies regardless of the services provided or treatments utilized. For instance, if you are struck by a duck or have a subsequent encounter with a duck after being struck, the code is; W61.62XD whether the treatment is reattaching a severed finger or extracting feathers from your lungs. Now, if it's a macaw, rather than a duck, you'll need code W61.12XA. If you walked into a lamppost or have subsequent injury after walking into a lamppost the code is W220.2XD. If you're water skiing and your water skis catch fire the code is; V91.07XD. If you're injured in a spacecraft collision (occupant, not pedestrian) the code is; V95.43XS.
The idea that they don't have a code for COVID-19 makes it seem like every bureaucrat and healthcare professional who's participated in setting up and operating the ACA seem like a myopic quack.
Yes, those ICD 10 diagnosis codes are both funny and confusing.
I believe you up coded the spacecraft collision code, the modifier XS is for subsequent encounters.
The initial encounter may not require the XS modifier.
Be careful not to upcode!
There are severe criminal penalties for making an honest mistake in medical coding.
We do some of the same operations so often that I have made up a rubber stamp to write treatment codes 66984 and 67036.
The patients look at me funny using a rubber stamp on my phone, but writing 66984 thirty times in one day gets old, fast.
Since it is “free “, look for the price of teststo increase by hundreds of dollars.
Biden will not order medicare or medicaid to pay for such tests, organizations he might reasonably have the power to direct.
But where does he get off altering the contracts for coverage, and non-coverage, that exists between insurers, and the private payors of the private insurance?
Seems like Biden is trying to fail here, in as many ways possible, in a manner that is visible to every person in the country.
-tests not easily available
-those with discretionary money will buy them if they can on their own dime, with little hope of actual reimbursement
-those without private insurance (unemployed, medicare, medicaid) will have to do without possible reimbursement
Seems like Biden is trying to fail here, in as many ways possible, in a manner that is visible to every person in the country.
If you aren't going to be able to climb through the Overton Window, might as well jam the sash as close to the ceiling as you can get it for anyone who may want to follow you.
What is the law authorizing this action? Obamacare (PPACA)? Is there any limit to what a President can order insurance companies to pay for under that law or are they simply at the mercy of the administration's whims, like in a properly fascist country?
The latter, if Dems can sneak the election laws into some pork somewhere... Like putting fundamental changes to our elections up for vote at 4am in a NASA spending package.
I thought that as a result of Katie Bell's heroic badgering of the previous CDC director in the 2020 Congressional hearings, the CDC was supposed to be paying for everyone's testing all the time (not that she ever same Congress thought to appropriate money to cover such an expenditure through that agency).
Just thinking back on it has me trying to imagine the china syndrome level response that we'd see out of Walensky if she were to be exposed to similar treatment in one of those hearings. Maybe just ask her why there's been so many instances where she's seemed to be publicly saying the near opposite of what the agency she runs is putting out on the same or prior/next day?
She's now saying there were some errors in communication, and the CDC really should have made it more clear that The Science can change a lot.
For us unsophisticated folks, it means that moving goalposts, lying to the nation and defaming scientists that said a contrary word are things we will never get an apology for, and can expect more of in the future.
Are we still on this schtick that the jab prevents Covid? Even CNN is recognizing that's bullshit.
Relevant - Gen. Milley, fully jabbed with booster, just came down with Covid. Maybe if we stick him a few more times it'll work?
Dragging their feet on something as simple as at home testing but rush right ahead without any debate on vaccine boosters for kids without a shred a evidence. That is the FDA.