Vermont is requiring insurance companies to cover the cost of rapid COVID tests, according to an emergency rule announced this week.
Effective immediately, Vermonters with commercial insurance can get reimbursed for the cost of rapid COVID tests purchased as early as Dec. 1.
The state has also promised to make rapid tests available at pharmacies with no upfront cost for most Vermonters with health insurance.
“Our hope is that by the Christmas and New Year's holidays, the pharmacy component could potentially be in place,” said Michael Pieciak, commissioner of the Department of Financial Regulation.
Under the scheme, pharmacies could submit claims to insurance companies directly.
“What we're trying to do is make it so that a Vermonter could walk into the pharmacy, the pharmacist could have the prescription for the at-home COVID test,” said Sara Teachout, of BlueCross BlueShield of Vermont. “Then the person getting it wouldn't have to pay upfront.”
The state's approach is different than recent guidance announced by the Biden administration, which calls on making over-the-counter rapid tests more readily available by allowing individuals to pay for the tests and then get reimbursed by their insurance company.
The state’s rule also doesn’t cover the costs of rapid tests for Vermonters without health insurance, or mandate coverage for people under self-insured health plans, offered by many large companies.
Rapid tests have been heralded by public experts as a vital tool in reducing the spread of COVID. But insurance companies, pharmacies and state officials have admitted that implementing the plan on a short timeline, with limited availability of tests, poses challenges.
“We're certainly scrambling,” Teachout said.
While national pharmacies might have more purchasing power than independent pharmacies, many chains face severe workforce shortages, according to Lauren Bode, who leads the Vermont Pharmacists Association.
“We’re hearing from some pharmacy owners that they can’t get a lot of these tests,” she said.
When New Hampshire launched its free rapid COVID test program at the end of November, interest was so large the initial supply ran out in 24 hours.
Bode worries about the impacts of adding to pharmacists' already overburdened workload.
"It's getting harder and harder to continue to add responsibilities right now," she said. “I wouldn’t want to be in a system where this would take away from our ability to provide COVID boosters, and flu shots, and provide other components of essential medical care.”
Lexi Krupp is a corps member for Report for America, a nonprofit national service program that places journalists in local newsrooms to report on under-covered issues and regions.
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