Employer Health Plans Must Cover Costs of At-Home COVID Tests
As of January 15, 2022, employer-sponsored group health plans (as well as insurance companies) are required to fully cover eight over-the-counter at-home tests per covered individual per month, as explained in DOL guidance. These tests must be for personal, and not employment, purposes. If ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions, there is no limit on the number of tests, including at-home tests.
There can be no cost-sharing requirements (e.g. deductibles, co-payments, coinsurance, prior authorization or other medical management requirements). The insurer or plan may reimburse sellers directly, or may require employees to submit claims for reimbursement, up to $12 per individual test.