How over-the-counter (OTC) Covid-19 tests will be covered by Health Insurance Carriers

Hove COVID Test

As of January 15, 2022, health plans are required to cover the cost of 8 FDA approved over-the-counter (OTC) in-home diagnostic tests, per member per month.


The guidance is applicable to self-insured and fully insured group health care plans, including grandfathered health plans (“plans”):

  • Plans and issuers must cover the cost of OTC COVID-19 tests, including tests obtained without a health care provider’s order or authorization.
  • Coverage must be provided without cost-sharing (deductibles, co-payments, and coinsurance) or prior authorization requirements.
  • Plans must reimburse participants for the cost of testing per the plan’s claims procedures. Plans are not required to reimburse sellers of the kits directly but may do so voluntarily.
  • The guidance “strongly encourages” plans to provide direct coverage for OTC COVID-19 tests by reimbursing sellers directly without requiring participants to seek reimbursement.

  In addition, anyone can order and receive free testing kits online by visiting the link below
Free Government Covid-19 testing kits or by visiting https://special.usps.com/testkits.


View Carrier-Specific Test Kit Info (PDF)

 

 

Coronavirus Update

Covid 19 microscope virus detail

There has never been a more important time to have access to the best advice available, and this may be the greatest challenge of our generation.  We’re here to provide our expertise in navigating these unchartered waters. 

We have formalized a COVID-19 support team to harness our deep resources, making them available to your organization as you navigate the fast paced and compounding impacts of this global pandemic.  Our entire staff met and decided to pack up our workstations last week and move operations to our home offices to ensure we don’t miss this opportunity to be there when you need us.  We have experts in HR, finance, and taxation should you need assistance or a referral at this time.

Health insurers are responding to the COVID-19/Coronavirus threat by offering members no-cost screening and diagnostic testing.  At this time, carriers are still working on details surrounding whether they can offer premium deferral or extended grace periods for businesses impacted by shutdowns. Most carriers have a 30-day grace period before coverage is cancelled – however this can change pending any intervention by the Federal Government to modify or extend this.  Whether you are looking to furlough, terminate, lay-off, or reduce hours for any of your staff, we are here to help explain your options.  Your employees are all COBRA eligible, however there are other health insurance options for them that may be available should the reduction in income leave them unprepared to pay for COBRA at this time.  Jonathan Benet in our office is our COBRA/Individual & Family Plan expert and ready to help.  

In addition, we are working with our team to create other resources that cover everything from SBA emergency loans, updates on tax filing extensions, disease prevention policies, asset preservation/cash flow projections, tax deductions unique to this situation, human resource updates, health and wellness while working from home, plus many more.  Stay tuned for time(s) and date(s) of our upcoming live webinars.  Please note we will be recording them and making the recordings, as well as a plethora of other resources available on our website in this special COVID-19 section.

Details surrounding the coronavirus are changing constantly. We will update these resources as soon as they become available. 

B Wood – COVID-19 Group Health Insurance Resources 

(insurance carrier specific information on health insurance carriers tele-medicine, e-visits, and phone support lines)

B Wood-SDHR Consulting COVID-19 Employer Webinar 3/13/2020  
(recorded B Wood Insurance webinar reviewing Coronavirus on what employers need to know)

Kaiser Permanente COVID-19 Informational Video Series
videos on COVID-19 symptoms, prevention, if you get sick, how is Kaiser prepared to deal with it, etc.

Helpful Links:

California’s Labor Rules on COVID-19 :https://www.labor.ca.gov/coronavirus2019/
Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/index.html
World Health Organization:  https://www.who.int/health-topics/coronavirus  
California EDD: https://edd.ca.gov/about_edd/coronavirus-2019/faqs.htm
White House Corona Virus Updates:  https://www.whitehouse.gov/
California Department of Public Health: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx
State of Calif EDD https://edd.ca.gov/about_edd/coronavirus-2019.htm#Employer%20Assistance
Employer specific questions follow this link:  https://edd.ca.gov/about_edd/coronavirus-2019/faqs.htm
Cal/OSHA :  https://dir.ca.gov/dosh/coronavirus/Health-Care-General-Industry.html
State of Calif Labor Commissioner’s Office:  https://dir.ca.gov/dlse/2019-Novel-Coronavirus.htm