Ive here. This article oddly misses a key point about the economics of health insurance companies. They’re doing so well under Covid that they can barely complain about the cost of the tests, especially since many Americans will get 4 tests per household in the mail first, since it’s a very low job/risk deal (ordered online and delivered). But of course, anyone other than one’s household with members out and about in a dangerous environment could quickly pass a large number of tests.

But back to “oh, so sad, the insurance company has to eat the bill”. When a large number of insureds are postponing elective surgery, they have been charging the same premiums through Covid (all due to post-lockdown MD/OR backups, and the prudence of being willing to treat only when case numbers aren’t too high) even on a regular basis access, such as inspection. I doubt the cost of these tests will bring their profits down to pre-Covid levels.

However, the article usefully points out tricks and pitfalls in the policy, such as the (low) reimbursement cap and the fact that the plan oddly doesn’t cover Medicare recipients.

And yours does keep filing medical claims, but for those who aren’t used to it, that’s another point of failure.

By Damon Darling.Originally Posted in Kaiser Health News

Americans have been hearing about the importance of frequent home testing for covid-19. But just try to find a quick “at home” covid test in the store at a price that makes frequent testing affordable.

Testing, along with wearing masks, is an important measure if the country wants to beat the virus, get back to normal daily life and keep the economy running efficiently. To give Americans access to cheaper tests, the federal government now plans to make insurance companies pay for it.

Biden administration Announced on January 10 Everyone with private insurance can get full coverage Eight rapid tests per month. You can buy from retail pharmacies that are part of the insurance company’s network without any out-of-pocket costs, or at any store and be reimbursed by the insurance company.

Congress says private insurers are Families First Coronavirus Response Act and Coronavirus Aid, Relief and Economic Security or CARES Act. During a pandemic, “pay with insurance” solutions are often used. Insurers have been told to pay for PCR tests, coronavirus treatments and vaccinations. (Taxpayers pay for the vaccine themselves.) For politicians, this seems like an elegant solution because it appears to be free and doesn’t use taxpayer money.

1. Is the test really free?

Well, no. As many economists will tell you, there is no free lunch. Someone has to pick up the tag. Initially, the insurance company covers the cost. Cynthia CoxThe total bill could run into the billions, said the KFF vice president, who studies the Affordable Care Act and private insurers. How much depends on “how easy it is to get them, and how much is reimbursed,” she said.

2. Will the insurer swallow these imposed charges?

If companies were to learn from the time-tested insurance giant’s playbook, they would pass those costs on to customers. “This will put upward pressure on premiums,” said Emily Gee, vice president and health policy coordinator at the Center for American Progress.

Major insurers including Cigna, Anthem, UnitedHealthcare and Aetna did not respond to requests to discuss the issue.

3. If so, why haven’t I received a higher premium?

Insurers had the opportunity to raise premiums last year, but mostly they didn’t.

why? Maybe because insurers have made so much money during the pandemic so far, they don’t need to. For example, according to the National Association of Insurance Commissioners, profits for the industry rose 41% to $31 billion in 2020 from $22 billion. The NAIC said the industry continued its “huge growth trend” that began before the coronavirus emerged. The company will report 2021 results shortly.

The reasons behind these profits are clear. The premiums you pay are based on predictions made by your insurance company about how much healthcare consumers will use for the year. Insurance companies pay less as people stay home, have fewer accidents, postpone surgeries, and often avoid doctor or hospital visits. They return some of the revenue to customers, but they earn more.

As the company’s actuaries work to forecast payouts in 2023, premiums could rise if they foresee more claims and expenses. Paying millions for rapid tests is part of their calculation.

4. Does the test cost money regardless of my premium?

It’s quite possible. If your insurance company doesn’t have an agreement with the retailer, you can simply pick up the assigned test, and you’ll have to pay — regardless of the price set by the store. If this is the case, you will need to fill out a form asking for reimbursement from the insurance company. How many times have you lost a receipt, or just ignored a rebate for mailing something you purchased? A lot, right?

Here’s another thing: reimbursement is set at $12 per test. If you pay $30 for a test — which isn’t unheard of — your insurance company will only pay $12. You eat for $18.

By the way, people with Medicare will have to pay for the test themselves. People on Medicaid can get free test kits at community centers.

Some free tests should reach every American home through the U.S. Postal Service.The Biden administration has Activate website Americans can order free tests from a $1 billion cache ordered by the federal government.

5. Does this help reduce the cost of home tests and make them easier to find?

Free covid tests are unlikely to have a direct impact on general cost and availability. You still need to search for them. Federal measures could spur demand for tests, which could make them harder to find in the short term.

But demand, along with some government reassurances to manufacturers, could push test makers to make more products faster. In theory, increased competition and supply could lower prices. Analysts estimate that with the wholesale cost of testing in the $5 to $7 range, there’s definitely room for prices to come down. “This is a huge step in the right direction,” Gee said.