The Secretary of Health and Human Services has renewed the public health emergency determination due to the COVID-19 pandemic. The current determination became effective on April 16 and will last until July 15, 2022. For the duration of the public health emergency:

Vaccinations. The COVID-19 vaccine must be covered without cost sharing, as a “preventive service,” whether delivered in-network or out-of-network.

COVID-19 tests ordered by a health care provider / by prescription. When medically indicated, an unlimited number of COVID-19 tests must be covered at no cost to participants, whether delivered in-network or out-of-network.

COVID-19 tests without a prescription / health care order. Beginning January 15, 2022, and through the duration of the public health emergency, plans must provide at least eight (8) OTC COVID-19 tests per individual, per 30-day period (or per calendar month). Plans cannot limit the number of OTC tests to a smaller number over a shorter period, e.g. four (4) tests per 15-day period. This applies only to OTC tests without a healthcare provider order or prescription. Plans can provide coverage either through a reimbursement model or direct coverage. For limits and safe harbor information, see our At Issue FAQs.

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