Biden Administration Announces At-Home Covid Testing To Be Covered By Insurance:
On Jan. 10, 2022, the U.S. Departments of Health and Human Services, Labor and Treasury (“the Tri-Agencies”) released FAQ, Part 51, regarding coverage for COVID-19 testing by health insurers and group health plans. The guidance instructs on the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and the Affordable Care Act (ACA).
The Tri-Agencies provided further clarification on how – during the public health emergency (PHE) – members in group or individual health plans can seek reimbursement from their plan or issuer for U.S. Food and Drug Administration (FDA)-authorized diagnostic home tests purchased on or after Jan. 15, 2022, and what a health plan or issuer should do to facilitate that.
• The revised guidance will apply through the end of the PHE.
• Coverage will begin for claims submitted with dates of purchase on or after Jan. 15, 2022.
• Members do not need an order from a health care provider or clinical assessment to purchase a home test, but tests must still be primarily for individualized diagnosis or treatment of COVID-19.
• The policy applies to fully insured, self-funded (ASO) and Level Funded health plan customers.
• Tests are limited to eight tests per 30 days for each member in a subscriber’s plan. In applying the quantity limit of eight tests, plans and issuers may count each test separately, even if multiple tests are in one package.
Please note that this was recently announced and there is currently very little logistics set up within insurance companies on how to actually handle this as there are no retail store networks, billing codes ,etc. We will keep you posted. Learn More Here.
United States Fire Insurance Company Withdrawing Health Insurance:
Many of you have never heard of them. However, some of our customers have asked about the US Fire "Simple Term" health insurance and we advised avoiding them. Why? Because when US Fire originally contacted us to offer their plans, they could not answer direct and easy questions. Questions such as what and how are specific claims covered, what constitutes as "preventative care", when and how are premiums billed, etc. This was a bad sign and it now shows as US Fire is no longer offering their "Simple Term" health insurance plans.