August 13, 2022

Healthy About Liver

Masters of Health

UVM insurance plan won’t pay for Covid-19 antigen tests, despite state advice

A rapid antigen Covid-19 test is performed on Friday, Dec. 17, 2021. The University of Vermont has declined to cover at-home antigen tests for people on their insurance plan. Photo by Glenn Russell/VTDigger

In an emergency rule issued earlier this month, Gov. Phil Scott mandated that private health insurance companies cover the cost of at-home antigen Covid-19 tests for their customers. 

And while Vermont couldn’t compel companies that manage their own insurance to do the same, it encouraged employers that have self-insured plans to “voluntarily follow the rule in anticipation of new federal regulations” that are expected to take effect in mid-January. 

Now, the University of Vermont — one of the state’s largest employers — has declined to follow Scott’s lead.

As health officials await an expected spike in Covid-19 cases stemming from the Omicron variant, the demand for at-home antigen tests has soared. With a quicker turnaround than the slightly-more-accurate PCR tests, antigen tests have been hailed as a convenient safety check before gathering with other people.

But aside from those availing themselves of the 60,000 antigen tests to be distributed by the state over the holidays, Vermonters seeking at-home tests generally must visit a pharmacy and reach for their wallets. Whether they’re grabbing cash or an insurance card, however, can depend on their health coverage. 

For Aimee Picchi, it was her credit card. Picchi, who gets her health insurance through the University of Vermont, said she paid $100 to get 10 tests for herself and her family last week. The 51-year-old Burlington resident wanted to have some tests on hand since her daughter was coming home from college in New York City, and the family had plans to attend a few holiday gatherings.

After ordering the tests online through CVS Pharmacy, Picchi heard about the Scott administration’s emergency rule, and tried to get reimbursed for the $100 she paid. But the insurance company that administers UVM’s insurance plan told her that wasn’t possible. 

“Your employer group, who manages your insurance policy, has informed us that they opted out of providing benefits for the at-home COVID-19 antigen tests,” the email from Blue Cross Blue Shield of Vermont read.

Missing out on the $100 credit didn’t drain Picchi’s bank account, she said, but the university’s decision to opt out of the benefit could hurt others who were less financially stable.

“A lot of people don’t have an extra $100 to spend on things like that,” Picchi said. Covering the antigen tests “seems like such a good strategy for keeping people healthy.”

When Picchi’s husband, university employee Peter Dodds, shared his wife’s discovery on Twitter, Dr. Timothy Lahey — an infectious disease doctor and ethics chief at the University of Vermont Medical Center — publicly criticized the university’s policy.

“Siri, show me an example of the phrase, ‘Penny wise and pound foolish,’ ” Lahey said in a quote tweet

In an email to VTDigger, UVM spokesperson Joel Seligman said the school offers free Covid-19 testing to all its employees through the university’s on-campus testing center.

The testing center, which offers PCR testing, is closed from Dec. 21 to Jan. 4 for the university’s winter break, according to its website.

The testing center also wouldn’t serve people who, like Picchi, get health coverage through the school but aren’t employees.

Antigen tests are available to UVM employees who have symptoms of Covid-19, though they are not performed in the testing center, Seligman said.

Seligman pointed out that, as a self-insured institution, UVM is exempt from the Scott administration rule.

“We regularly review employee medical benefits to determine what changes might better serve UVM’s workforce within the bounds of affordability for both employees and the university,” Seligman said. He did not specify how regularly the university reviews its medical benefits. 

UVM’s policy runs against the advice of state officials, who suggested that self-insured employers might have to make at-home antigen tests free next month when President Joe Biden’s most recent coronavirus plan kicks in. 

“Organizations that self-insure are governed by federal law and thus fall outside the scope of our recent rule about coverage for at-home Covid-19 tests,” Mike Pieciak, commissioner of the Department of Financial Regulation, which oversees insurance, said in a statement to VTDigger on Wednesday. “We … anticipate that they will be covered by the federal rule the Biden Administration anticipates implementing in early 2022 that will require similar coverage.”

The university recently cited imminent federal action as a justification to mandate Covid-19 vaccination among its employees.  

State officials say the emergency rule will make at-home antigen tests free for about 140,000 Vermonters. A spokesperson for the Department of Financial Regulation didn’t provide an estimate for how many workers won’t get the tests covered by their insurance plan. 

Some large employers in Vermont that run their own insurance plan do cover antigen tests, including the University of Vermont Health Network and National Life Group.