Senators want Medicare to reimburse at-home COVID-19 tests just like commercial insurers

A group of Democratic senators is happy the Biden administration is requiring commercial insurers to cover at-home COVID-19 tests for customers but questions why Medicare isn’t doing the same thing for seniors.

The group of 19 Democratic senators wrote to Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) leadership Monday seeking answers on the lack of testing reimbursement.

“Seniors and people with disabilities enrolled in Medicare are at the highest risk of severe illness from COVID-19, and people over 65 account for nearly three-quarters of all deaths from the virus,” the letter led by Sen. Debbie Stabenow, D-Michigan, reads. “The current policy leaves them on the hook for potentially significant out-of-pocket costs.”

Jan. 15, commercial insurers started to reimburse at least eight at-home tests for consumers a month. The requirement from the Biden administration comes in response to a massive surge of the virus caused by the highly transmissible omicron variant.

The administration also expanded free testing sites in pharmacies and community health centers and will mail four at-home tests per person via the website COVIDtests.gov.

The lawmakers said the new requirements for insurers to cover at-home tests will “significantly expand access to millions of Americans with commercial health insurance.”

But there remain questions surrounding whether consumers may face barriers getting reimbursement for the at-home tests from their commercial insurance plans. An analysis from Kaiser Family Foundation of 13 major insurers found seven of them are not using a direct coverage option such as a preferred pharmacy. It also found four of the insurers are requiring insurers to mail in or fax the receipt for the tests, while others offer online options.

CMS did not return a request for comment as of press time on the request.