Health insurers address how at-home tests will be covered come Saturday

PITTSBURGH — Channel 11 has contacted several private health insurers to see how companies intend to cover at-home tests for members, which the Biden administration is requiring come this Saturday.

As part of the federal mandate, insurers must cover up to 8 tests per member, per month.

Highmark, according to Bob Wanovich, Vice President of Provider Contracting, said “we are staffing up and we’re making sure that we’re prepared to handle those incoming claims.”

To start, Highmark members will have to purchase the tests on their own. They’ll need to save their receipts, the test’s UPC symbol, and upload that information through a manual claim form on the online member portal.

“We will be asking people to attest that this is for their own personal use,” Wanovich said. “I think that’s really important for people to understand. This is not meant for people to stockpile tests. We don’t want people buying tests and selling them.”

After submitting a claim, members will receive a check in the mail.

In the meantime, Highmark is working to establish a preferred network, where folks will eventually be able to get tests without having to pay for them upfront.

“It will be more like what they’re used to, where the provider submits it to us,” Wanovich said. “We won’t have that mechanism set up on Saturday when this starts, but we are working very aggressively to get that set up as quickly as possible.”

That network is expected to include several common and accessible pharmacies.

In the meantime, it’s not quite clear how every other insurer intends to handle the claims.

A spokesman for Aetna, part of CVS Health, simply provided us with this statement: “Access to testing has been a critical component of our pandemic response. We are reviewing the guidance and plan to adjust our coverage policies as appropriate.”

A spokesperson for UPMC Health Plan sent us the following statement:

“UPMC Health Plan is actively assessing the implementation requirements and implications of this new policy. There are significant complexities associated with this new mandate that require unique solutions, and we are committed to comprehensively and efficiently administering this benefit in full compliance with the new federal requirements. We appreciate that members are eager to understand the policy details and we are working diligently to define the necessary operational parameters and accelerate implementation of the policy.”

We followed up to ask what members should do in the meantime, if they wish to purchase at-home tests come Saturday.

“Members who purchase tests on or after January 15 should save their payment receipts and test packaging with bar codes,” a spokesperson responded. “UPMC Health Plan will have additional details about how to submit requests for reimbursement very soon.”

Questions we sent to a United Healthcare spokesperson had not been answered by the time this article was published.

President Biden addressed Americans who don’t have coverage during an address on Thursday.

“For those without insurance, we have over 20,000 free testing sites all around the country,” Biden said. “You can find the nearest testing sites near you by Googling ‘COVID test near me.’”