With the current COVID-19 surge, more people are needing tests than ever before. The high demand has made COVID-19 tests difficult to come by, and many are forced to wait hours just to be tested.
At-home COVID-19 tests are a more convenient (though less accurate) option for people struggling to secure a testing appointment, and President Biden recently announced employees can be reimbursed by their insurance plan for these, starting on January 15.
5 things to know
Just days ago, the Department of Health and Human Services and the Labor and Treasury Departments released guidance clarifying the president’s announcement.
Here are they key points that were announced, and what this means for employers.
- No doctor required. Employees don’t need a doctor’s visit or recommendation in order to be eligible for at-home test reimbursement. While the government prefers employers reimburse at-home test retailers directly, you can require employees to front the money, then submit a reimbursement request.
- Employees should get tests from preferred pharmacies/retailers. Employers have to reimburse for all at-home tests purchased at pharmacies and preferred retailers. However, if an employee buys a test out of network, employers are only required to reimburse up to $12 for the test (or less, if the total cost of the test was under $12).
- Limit of eight tests per 30 days per covered individual. Employers are only required to reimburse up to eight at-home tests per month, per qualifying individual. However, there is an exception. If an employee exceeds their allowed eight tests but gets a doctor’s order requiring another, the employer must cover it.
- Employers can take steps to prevent abuse. If an employer suspects an employee is securing tests for someone not covered by the insurance plan, it can require the employee to show proof of purchase and attest the test was for themselves.
- Employers don’t have to cover tests for unvaccinated workers who are testing per company guidelines. If you have an unvaccinated employee who is required to test negative a certain amount of times per week as an accommodation, employers aren’t required to cover the cost of those tests.
Since this announcement is new, employers will likely need to work closely with their healthcare providers to iron out details. Employers should be prepared for hiccups and delayed reimbursements to occur.
HR and Benefits pros should also send out a communication to all employees explaining the reimbursement process and requirements.