Buzz
Recall the days of 2021 when individuals were desperate to locate COVID tests? In reaction, the government initiated the distribution of free tests and required insurance companies to reimburse up to eight tests monthly. With private insurance, one could visit Walgreens, request a prescription for COVID tests from the pharmacist, and leave with a bundle of tests at no cost, irrespective of their insurance plan.
Fast forward to Spring 2023, and the public health emergency declaration is set to end on May 11, taking the reimbursement pathway with it. While private insurers might still opt to cover COVID testing, the likelihood is slim. Here’s why testing remains important, where to find tests, and how to ensure your insurance company reimburses you before the deadline. You still have time to claim reimbursement for 16 more tests before the policy expires.
Yes, testing is still essential
Yes, it's highly probable that you will contract COVID-19 multiple times throughout your life. Scientific research indicates that each infection, regardless of symptom severity, increases your risk of developing Long COVID. COVID-19 is now understood to affect the vascular system, with emerging evidence showing that microclots can cause neurological, cardiovascular, and pulmonary issues. Symptoms can range from temporary fatigue and elevated heart rate to more severe conditions like COVID toe or brain fog. Additionally, the surge in colds, flu cases, and fungal infections may be linked to our overburdened immune systems. While these issues may seem minor compared to the immediate threat of death, Long COVID is disabling many individuals, preventing them from working, and it’s affecting more than just the elderly or those with pre-existing conditions.
Minimizing your viral load during each infection and reducing the number of infections is crucial. Tools like Paxlovid, primarily recommended for those at risk of severe outcomes, have been shown to benefit most people by lowering the risk of Long COVID by up to 30%. To access Paxlovid, you need a positive test result and must obtain a prescription within the first five days of symptoms.
Current options for COVID-19 testing
The widespread testing centers that once populated city streets and parking lots have largely disappeared. With the closure of major testing providers like Curative and Carbon Health, access to fast, government- or insurance-covered testing has diminished. These centers typically offered PCR or molecular tests, which are far more accurate than the rapid antigen tests commonly used at home. Research shows that rapid antigen tests (RATs) often produce inaccurate negative results during the first 5-6 days of infection, whereas PCR/molecular tests remain reliable during this period.
Home tests, available at drugstores, Costco, Amazon, and most grocery stores, are primarily rapid antigen/lateral flow tests. While they are less reliable for early detection, a positive result is almost always accurate. These tests are useful for determining when you’re no longer infectious, as the five-day rule is more about economic pressures than scientific evidence.
For PCR or molecular testing, you have two choices: visit a facility like urgent care or a travel testing center, or invest in newer at-home molecular tests. Currently, two companies provide these tests: Cue Health offers a hub and individual rapid molecular tests, though they are pricey at $50–$75 per test. On the other hand, Lucira Health provides a molecular test for $25–$35. With the $12 per test reimbursement, your out-of-pocket cost drops to $13 per test.
How does the reimbursement process function?
To obtain rapid antigen tests, the simplest method is to contact your pharmacy and request your monthly allotment of eight tests. Your pharmacist can handle the prescription. Most health insurance plans have pre-arranged agreements with major chains like Walgreens, RiteAid, and CVS, so all you need to do is pick them up once they're ready.
Ordering tests online is slightly more complex, especially for rapid molecular tests, which must be purchased online. First, confirm that your insurance covers them (most insurers typically cover Cue and Lucira). You’ll need to pay upfront and keep your receipt. Insurance companies require you to complete a reimbursement form, which can be tricky to locate. The quickest way is to call your insurer and request the form. Since this is a pharmacy reimbursement, contact the pharmacy number on your insurance card for faster assistance. Submit the completed form with your receipt, and expect reimbursement within about eight weeks.
Although the reimbursement program ends on May 11, claims for purchases made before that date will still be processed. If you order tests now and again in 30 days, you can stock up for two months. Even if you don’t anticipate needing them, it’s wise to get them anyway. Use them to ensure safe interactions with immunocompromised individuals, such as elderly family members or long-lost friends. You can also gift them to others in need. Consider it a rare opportunity to hold insurance companies accountable—take advantage of it.
While the pandemic might be declared 'over,' the reality is that pandemics never truly end—they linger in ways that continue to impact us.
