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Insurance Coverage for Over-the-Counter COVID-19 Tests

As of January 15, 2022, private health insurers are required to cover up to eight at-home COVID-19 diagnostic tests per month for each person covered by a health plan. Tests must be authorized by the U.S. Food and Drug Administration (FDA) in order to be covered.

To meet this requirement, insurers may choose to provide direct coverage for tests by:

  • Establishing a program to have tests mailed directly to you upon request, or
  • Establishing a network of preferred providers that will enable you to go directly to a designated pharmacy or retailer to obtain free tests.

If your insurer does not provide direct coverage, 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.

DIFS has surveyed health insurers operating in Michigan and prepared the information below to help Michiganders understand this benefit and how it will be offered. This information is provided for informational purposes only. Check with your insurer for the most up-to-date information for your specific plan. Coverage should always be confirmed with your plan prior to purchasing any tests. DIFS is not responsible for any costs incurred in reliance on this information.

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 tests per month.
  • These tests are available without out-of-pocket cost at locations specified by your insurance company.
  • If you purchase a test at a retailer or pharmacy that is outside your insurer's preferred provider network, your insurance company will reimburse you up to $12 per test, or the cost of the test if less than $12. If your 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.
  • For information about your insurer's network of preferred providers and reimbursement process, see the information below.

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 tests per month.
  • You will have to pay for your 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 test.
  • Insurers may not apply deductibles, co-pays, or other cost sharing to at-home COVID-19 tests purchased under this new benefit.
  • For information about your insurer's reimbursement process, see the information below.

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

Insurers are not required to provide coverage for COVID-19 tests that were purchased prior to January 15, 2022. However, insurers may choose to reimburse consumers for these tests. See the information below to determine if your insurer is reimbursing for these tests.

If you're a Medicare or Medicaid Participant:

For information about insurance coverage for at-home COVID-19 tests, please see the Centers for Medicare and Medicaid Services FAQ.

All Michiganders are eligible to order free at-home COVID-19 tests from the federal government at COVIDTests.gov.

Consumers who have questions or concerns that cannot be directly resolved with their insurer can contact DIFS Monday through Friday 8 a.m. to 5 p.m. at 877-999-6442 or file a complaint online at Michigan.gov/DIFScomplaints.