How to Get Reimbursed for COVID Tests Before Insurance Stops Paying
Remember back in 2021, when people were willing to do anything to find a COID test? In response, the government started sending out free tests, and then mandated that insurance had to reimburse you for eight tests a month. If you had private insurance, you could drop into Walgreens, ask for a script for COVID tests from the pharmacist, and walk out with a stack of tests without laying down a dime, regardless of your coverage.
But here we are in Spring 2023, and the public health emergency declaration is going to expire on May 11, and with it, that avenue for reimbursement. To be clear, private insurance could still choose to cover COVID testing, but hahaha. So here’s why you should still test, where to find tests, and how to get your insurance company to pony up so you’re stocked before time runs out. There’s still enough time to get 16 more tests before reimbursement runs out.
Yeah, you still should test
Yes, you are likely going to get COVID. (Again?) And then get it again. And again. Over the course of your life, you will likely get it at least a few times. Science says that each of these infections, no matter how you feel during the course of the infection, contributes to your risk of Long COVID, and that many more people experience Long COVID than we realize. COVID is now recognized as vascular, and growing evidence shows that microclots lead to neurological, cardiovascular, and pulmonary problems. Sometimes they’re as minor as fatigue and a higher heart rate lasting a few weeks, but you probably know someone who has experienced other effects, like COVID toe or brain fog. There’s also evidence that the ongoing spate of colds our bodies can’t fight, the flu, and increases in fungal infections are an indirect result of our overtaxed immune systems. While these might all seem like small issues because the risk of near-term death is no longer omnipresent anymore, Long COVID is causing a lot of people to be disabled enough that they cannot work, and more than just the old and infirm are being affected.
It’s important to do whatever you can to minimize your viral load during each of those infections, and to get as few infections as possible. One of our tools are interventions like Paxlovid, which has been touted as being primarily for those with possible severe outcomes, though science says it will benefit most people, reducing your risk of Long COVID by up to 30%. The path to getting Paxlovid starts with a positive test, and you can only get a script for Paxlovid within the first five days of symptoms.
How to get tested right now
The testing centers that used to line streets in big cities and the parking lots of convention centers and fairgrounds are gone. When national testing conglomerates like Curative and Carbon Health decided to close down their testing centers, that meant less access to fast testing that was covered by the government or insurance. These were usually PCR or molecular tests, which are considered far more accurate than the common rapid antigen/lateral flow tests we have at home. In fact, there’s substantial proof that rapid antigen tests (RATs) provide inaccurate negative results for the first 5-6 days of infection, but a PCR/molecular test would be accurate during that time.
You can still obtain home tests from drugstores, Costco, Amazon, and most grocery stores, and they’re all going to be rapid antigen/lateral flow tests. They’re not bad, because a positive is almost always reliable, even if a negative the first few days is not. They’re good for the backend of infection, telling you when you’re no longer infectious (because the five day rule is a result of capitalism, not science).
To get a PCR or molecular test, you have two options: going someplace that offers the test, probably urgent care or a travel testing location, or pony up for newer, at home molecular tests. Two companies offer those tests now: Cue Health has a hub and individual rapid molecular tests, but they are expensive: $50–$75 each. But Lucira Health has a molecular test for $25—$35. With your $12 per test reimbursement, that’s $13 out of pocket each.
How does reimbursement work?
If you’re looking for rapid antigen tests, the easiest way to get them is to call your pharmacy and request your eight tests for this month. Your pharmacist can fill the script. In most cases, your health insurance has already negotiated with big chains like Walgreens, RiteAid, and CVS, so that’s all you’ll need to do. When they’re ready, go pick them up.
Ordering online is a little more complicated—and rapid molecular tests must be ordered online. First, ensure your health insurance covers them (in my experience, most insurers cover the two I’ve named above, Cue and Lucira). Next, you’ll need to pay for them upfront and hold on to your receipt. All insurance companies have forms you fill out to get reimbursed, and the real challenge is finding the form. The fastest route is to just call your insurance and ask. This is a pharmacy reimbursement, so ask for pharmacy or call the pharmacy number on your card to get there faster. Fill out the form, submit it with your receipt and you can expect a check in about eight weeks.
While the reimbursement ends on May 11, they’ll still pay out claims for purchases made before then, so if you order today, and again in 30 days, you’ll be able to stock 2 months of tests. Even if you don’t think you’ll need them, get them anyway. Use them to make sure you can safely spend time with people who are immunocompromised, like your aging parents or grandparents, or those friends you haven’t seen in three years. Gift them to people who need them. Get them just to put the screws to the insurance companies—it’s one of the very few times in your life you’ll be able to.
The pandemic may be “over”, but that’s the thing about pandemics: They’re never really over.