Insurance Coverage for at-Home COVID-19 Tests

​​​​​Last Updated: February 3​, 2022​​

As of January 15, 2022​, ​  all health plans are required to cover the cost of up to eight at-home COVID-19 diagnostic tests per month for each member of the plan. ​​​​​​​Tests are counted individually, not per box – i.e., four boxes with two at-home tests each equals eight tests.​ At-home t​ests may either be free or reimbursed by the insurer.​

To provide this coverage, insurers may choose to set up a network of pharmacies or retailers that will enable you to go directly to a designated pharmacy or retailer to obtain free, at-home tests. If your insurer does not establish a network of pharmacies or retailers, or if you purchase tests outside of your insurer's preferred provider network, you can request reimbursement for some or all of your out-of-pocket expense.

Check with your insurer for the most up to date information for your specific plan. Confirm your coverage before you purchase any tests.

If your insurer has a network of preferred providers:

• You can get up to eight at-home COVID-19 tests per month for every person covered on your health plan. For example, if four people are covered by your health plan, you can get up to 32 at-home tests per month.
• At-home tests are available without out-of-pocket cost at locations specified by your insurance company.
• If you purchase an at-home test at a retailer or pharmacy that is outside your insurer's network of pharmacies or retailers, your insurance company will reimburse you up to $12 per at-home test, or the cost of the test if less than $12. If your at-home tests cost more than $12 per test, you will not be reimbursed for the difference.
  
• Insurers may not apply deductibles, co-pays, or other cost sharing to at-home COVID-19 tests purchased under this new benefit.
  
  

If your insurer does not have a network of preferred providers:

• You can get up to eight at-home COVID-19 tests per month for every person covered on your health plan. For example, if four people are covered by your health plan, you can get up to 32 at-home tests per month.
• You will have to pay for your at-home tests up front and should save your receipts and test boxes for submission to your insurance company for reimbursement.
• Your insurance company will reimburse you for the full purchase price of each covered at-home test.
• Insurers may not apply deductibles, co-pays, or other cost sharing to at-home COVID-19 tests purchased under this new benefit.
  
  

If you're a Medicare or BadgerCare Plus member:

If you're uninsured:

• All Wisconsinites are eligible to order free at-home COVID-19​ tests from the federal government at COVIDTests.gov ​ ​.
• The state of Wisconsin has teamed up with Vault Medical Services to offer COVID-19 tests for everyone who lives in Wisconsin, with or without symptoms, at no cost. This ​service allows people to collect their own saliva samples at home and send them to a laboratory​ for testing. Visit ​COVID-19: At-Home Collection Kit​ ​ to learn more.
  
  

​Additional Information

If you purchased at-home COVID-19 tests prior to January 15, 2022:

• Insurers are not required to provide coverage for at-home COVID-19 tests that were purchased prior to January 15, 2022. However, insurers may choose to reimburse consumers for these at-home tests. Check with your insurer for details.​
  
  

Questions or Concerns

If you have questions or concerns about your insurance company or agent, contact the insurance company or agent involved. Keep a record of the conversations you have. If you do not receive satisfactory answers, you may contact the Office of the Commissioner of Insurance to file a complaint. ​ ​
​