Retired Army Capt. Michael Storm wanted to take advantage of a new federal plan that requires health insurers to pay for up to eight home coronavirus tests each month.
The home tests also won't be covered by Medicare, the nation's health insurance program that covers more than 61 million mostly older Americans.
“My wife is a schoolteacher, and every time she steps in the classroom she could be exposed (to COVID-19),” said Storm, a veteran of Vietnam and both Iraq wars. “We wanted to have the tests in hand for our family, to keep us safe.”
The Biden administration's mandate that began Jan. 15 calls for those with private health insurance to get a monthly allotment of free tests.
Health experts say the ambitious federal plan to quickly extend home testing will be challenging because of the nation's fragmented health care system.
Meena Seshamani, a deputy administrator at the Centers for Medicare and Medicaid Services, said in a statement that the agency is "Assessing any options to increase testing availability for seniors."
"Over-the-counter tests have not been paid for as a Medicare benefit, but we're going through the process now to explore options and work through statutory and regulatory issues as we drive toward solutions," Seshamani said.
In a letter to U.S. Department of Health and Human Services and CMS officials, the lawmakers said Medicare recipients, most of them older Americans but also some people with disabilities, are at higher risk for COVID-19 complications, and the absence of home-test coverage leaves them on the hook for potentially significant out-of-pocket costs.
Medicaid, the health program that covers more than 83 million low-income families and children through the Children's Health Insurance Program, has allowed payments for tests since August.
One key difference from private insurers, Rollins said, is that Medicaid programs are not allowed to reimburse recipients who purchase the home tests.
It's unclear how many Medicaid enrollees have accessed the free home tests, said Robin Rudowitz, Kaiser Family Foundation's director for the program on Medicaid and the uninsured.
Even if state Medicaid programs have authorized the tests, "I'm not sure enrollees know that is an option for them," Rudowitz said.
Medicaid recipients might be more likely to get home tests from community health centres and other distribution sites such as libraries, fire stations and public health departments, Rudowitz said.
