Originally Posted by
emcampbe
the regulations require insurance to reimburse up to $12/test (or $24 for a pack of 2). The Emed test packs that include proctoring are $150 for 6 or $25/test. While some insurance companies might just reimburse the whole thing, some specific plans could even require it I suppose, they are well within their rights to simply reimburse 12 x 6 or $72 of the cost and no more.
Because they are prescribed by a doctor (and the prescription appears from an emed doctor attached to the order on the emed account), my insurer has paid these in full even before the home-testing regulations went into effect. They are covered as any other doctor ordered COVID test.
For example, see below, with the text I bolded at the end: prescribed tests are different from the OTC tests.
What if I buy more than one test at a time?
GEHA is required to provide reimbursement for 8 tests per rolling 30-day period per covered member, meaning 8 tests per GEHA subscriber plus 8 tests per spouse, child or other dependent who’s covered on the subscriber's plan. That means, for example, a family of four can be reimbursed for 32 tests per rolling 30-day period, regardless of whether the tests are bought all at once or at separate times throughout the rolling 30-day period. GEHA recognizes that some OTC COVID-19 tests are sold in packages containing more than one test. In applying the quantity limit of 8, GEHA may count each test separately, even if multiple tests are sold in one package.
GEHA will continue to cover COVID-19 tests if they are ordered by a physician, non-physician practitioner, pharmacist or other authorized health care professional.