Vermont adopts emergency rule expanding insurance coverage for rapid home COVID-19 tests

Montpellier, Vermont. – The Vermont Department of Financial Regulation has issued an emergency regulation that will require health insurers to cover the retail purchase of most home testing of COVID-19 antigen authorized by the FDA. The emergency rule covers Vermonters who purchase commercial insurance in the Vermont personal, small and large group markets, as well as the Vermont Education Health Initiative.

When fully implemented, there will be no upfront cost and home testing will be processed as part of an individual’s pharmacy benefit with the pharmacy requesting reimbursement. Those who purchase the tests outside of a pharmacy will need to submit a claim for reimbursement to their insurer. Vermont currently does not have the power to extend the emergency to self-insured plans, but encourages them to voluntarily follow the rule in anticipation of new federal regulations recently announced by the Biden administration.

“Removing financial barriers to testing and treating COVID-19 has been an important part of Vermont’s response to the pandemic,” said Department of Financial Regulation Commissioner Michael Pieciak. “Making COVID-19 testing free and accessible helps limit the spread of the virus by quickly identifying positive cases, which is especially important as we continue the holiday season. “

Vermont continues to be one of the only states to eliminate insurance fees for people in need of COVID-19 treatment.

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