COVID-19 testing coverage: Guidance coming by Jan. 15

White House releases statement on at-home COVID-19 testing, potential cost implications

On Dec. 2, 2021, the White House released a statement announcing several actions to fight COVID-19, including requiring commercial health plans to cover COVID-19 at-home tests – approved or authorized by the Food and Drug Administration (FDA) – without cost-sharing. The White House has directed the Tri-Agencies (Departments of Health and Human Services, Labor and the Treasury) to issue guidance implementing this policy by Jan. 15, 2022.

The following information has been conveyed through the statement and press announcement:

·         The requirements will likely apply to fully insured, level-funded and self-funded group plans, including grandfathered and transitional relief business and business through the Exchanges.

·         The Administration preliminarily indicated the coverage requirements would not apply retroactively and would only provide coverage for diagnostic tests, as the current requirement stipulates.

·         Any requirements would likely extend through the Public Health Emergency.

UnitedHealthcare regulatory, clinical, actuarial, operations and COVID-19 testing teams are working to address and respond to the guidance when it is released.

The guidance is expected to impact 2022 health care spending. For example, at an average cost of $25 for 2 tests, and 6 tests submitted per member in 2022, the additional cost per member would be $75.

UnitedHealthcare will provide input to the Administration on how to best implement this new policy in a manner that balances access with affordability and patient safety.

Please contact your broker or UnitedHealthcare representative if you have questions or would like to learn more about advocacy efforts.

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