Montpelier, VT. — The Vermont Department of Financial Regulation has issued an emergency regulation that will require health insurers to cover the retail purchase of most FDA-authorized COVID-19 antigen at-home tests. The emergency rule covers Vermonters who purchase commercial insurance in Vermont’s individual, small and large group markets as well as the Vermont Education Health Initiative.
Once fully implemented, there will be no upfront costs and at-home tests will be processed under an individual’s pharmacy benefit with the pharmacy seeking reimbursement. Those purchasing the tests outside of a pharmacy setting will be required to submit a claim to their insurer for reimbursement. Vermont currently lacks the authority to extend the emergency to self-insured plans but encourages those to voluntarily follow the rule in anticipation of new federal regulations recently announced by the Biden administration.
“Eliminating financial barriers to COVID-19 testing and treatment has been in important component of Vermont’s pandemic response,” said Department of Financial Regulation Commissioner Michael Pieciak. “Making COVID-19 testing free and accessible helps limit the spread of the virus by identifying positive cases quickly, which is particularly important as we continue through the holiday season.”
Vermont continues to be one of the only states to eliminate out-of-pocket insurance costs for those requiring COVID-19 treatment.