The number of reported COVID-19 cases in Massachusetts and levels of the virus in sewage continue to rise as many people prepare to visit family for Mother’s Day weekend.
To avoid the spread of the virus, especially to people considered to be at high risk of serious illness, health experts advise people to undergo rapid antigen tests. And those tests, which used to be expensive and difficult to obtain, are now more available than ever.
Most Massachusetts residents can show their insurance card to get free quick antigen tests at the pharmacy of stores like CVS and Walgreen’s. Each policyholder is eligible to receive up to eight free tests each month, so a parent can get eight free tests for themselves and another eight for their child, as long as they provide both insurance cards.
In January, the federal government required health plans to reimburse their members for purchasing rapid tests. People could buy the tests out of their own pocket, then present the receipts to be reimbursed by their insurer. Some insurance companies have taken test orders on their websites and mailed them to members.
In recent months, in a change that is making quick tests more accessible, major pharmacies have begun offering the tests for free and processing them like any other prescription.
“Collecting receipts and sending them is your barrier,” said Stephen Kissler of Harvard TH Chan School of Public Health. “But if you can go to the pharmacy and collect them using your insurance card directly on the spot, it’s really useful.”
That free availability in pharmacies does not seem to be widely known. Even Kissler, who studies the effectiveness of rapid antigen tests, didn’t know they could be detected that way until GBH News asked him.
The January federal rule stated that prescription coverage in medical insurance plans should cover the cost of up to eight rapid antigen tests per person each month, although some stores limit customers to six tests. For Massachusetts consumers, that level of prescription coverage is required to meet federal and state minimum coverage mandates.
Massachusetts leads the nation with 97% of people having medical insurance, so this rule will vastly increase access across the Commonwealth.
According to the state office of health and human resources, the tests should be available free at pharmacies for people with coverage through MassHealth, which covers both Medicare and Medicaid beneficiaries in the state.
Massachusetts Association of Health plans state that all of its member insurance companies allow consumers to get quick tests for free by showing their insurance card.
“They worked with their favorite pharmaceutical partners to develop networks that their members could travel to and, at the point of sale, receive up to eight COVID-19 tests at home without having to pay upfront costs at the time of purchase,” said Elizabeth. Leahy from MAHP.
It doesn’t always work at the pharmacy counter. Although all health plans are federally obligated to reimburse rapid tests, some consumers shared with GBH News that they were turned down when they attempted to get the tests without an upfront and upfront payment.
“People should contact their insurer to confirm that you are eligible for this benefit,” Leahy said.
The state says there are also options for uninsured people to get free tests. The Office of Health and Human Services said they have distributed more than 10 million home tests to schools, shelters, community centers and other locations since January. Another million tests were recently distributed through local food banks.
Check your coverage
You can contact the member services phone number on your insurance card or visit your insurer’s website: Allways Health Partners, Aetna, BMC HealthNet Plan, Blue Cross and Blue Shield of MA, Cigna, ConnectiCare of Massachusetts, Fallon Health , Harvard Pilgrim Health Care, Health New England, Tufts Health Plan, or UnitedHealthcare Insurance Company.
Even though they are now better able to get quick tests, many people continue to be confused about when it’s best to use them and what exactly the test results mean.
Harvard’s Stephen Kissler said there are two times he finds the rapid tests most useful.
“The first is whether I’m going to see someone who might be at high risk,” Kissler said. “So if I’m about to see an older relative or someone with some comorbidities that would make it serious if they catch COVID, I usually get tested before I visit.”
The second time he will do a test, Kissler said, is if he has symptoms like coughing or if he’s been exposed to someone who had COVID-19.
“I will usually wait a couple of days, try to reduce the number of encounters I have with people outside my family, and then do a quick test – sometimes two – essentially to get rid of more regular daily contact,” he said. said.
The key information a quick test tells you, Kissler said, is whether you’re contagious at the time, so it’s best to get the test right before visiting an older or immunosuppressed loved one. And people should note, she said, that because it can take several days after exposure to become contagious, someone who tests negative today can become contagious – and test positive – tomorrow.
“A rapid antigen test is the best tool we have to tell me how I should behave,” Kissler said.
PCR tests, conducted in the laboratory and considered the gold standard, tell people if they have had COVID-19, but not if they are still infectious.
“I know it [from a PCR test] that I got infected with SARS-CoV-2 at some point in the recent past, but it doesn’t really give me much information on what to do now, “Kissler said.” The nice thing about quick antigen tests is that I they say in a few minutes a very good picture of whether or not I am at risk of infection for the people around me. And for me it is extremely precious “.