Insurance plan

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

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A rapid Covid-19 antigen test is performed on Friday, December 17, 2021. The University of Vermont has declined to cover home antigen testing for those covered under their insurance plan. Photo by Glenn Russell/VTDigger

In an emergency rule issued earlier this month, Governor Phil Scott required private health insurance companies to cover the cost of at-home Covid-19 antigen testing for their clients.

And while Vermont can’t require companies that run their own insurance to do the same, it encouraged employers who have self-insured plans to “voluntarily follow the rule in anticipation of new federal regulations” expected to come into effect. effective mid-January. .

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

As health officials await an expected spike in Covid-19 cases from the Omicron variant, demand for home antigen testing has soared. With a faster turnaround time than the slightly more accurate PCR tests, antigen testing has been hailed as a handy security check before getting together with other people.

But aside from those taking advantage of the 60,000 antigen tests to be handed out by the state over the holidays, Vermonters looking for at-home testing usually have to go to a pharmacy and reach for their wallet. Whether they grab cash or an insurance card, however, may 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 take tests because her daughter was home from college in New York and the family were planning on attending 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 a refund for the $100 she had paid. But the insurance company that administers UVM’s insurance plan told him that was not possible.

“Your employer group, which administers your insurance policy, has informed us that they have elected not to provide benefits for COVID-19 home antigen testing,” reads the e. email from Blue Cross Blue Shield of Vermont.

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

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

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

“Siri, show me an example of the phrase ‘Wise penny and mad pound,'” Lahey said in a tweet quote.

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

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

The testing center would also not serve people who, like Picchi, have health coverage through the school but are not employees.

Antigen tests are available for UVM employees who show symptoms of Covid-19, although they are not performed at the testing center, Seligman said.

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

“We regularly review employee health benefits to determine what changes might best serve UVM’s workforce within the limits of employee and university affordability,” Seligman said. He did not say how often the university reviews its medical benefits.

UVM’s policy flies in the face of advice from state officials, who have suggested that self-insured employers may have to make home antigen testing free next month when the latest plan to President Joe Biden’s coronavirus will go into effect.

“Organizations that self-insure are governed by federal law and therefore do not fall within the scope of our recent rule on Covid-19 home testing coverage,” said Mike Pieciak, commissioner of the Department of Financial Regulation, which oversees insurance, in a statement to VTDigger on Wednesday. “We … anticipate they will be covered by the federal rule that the Biden administration plans to implement in early 2022, which will require similar coverage.”

The university recently cited impending federal action as justification for mandating Covid-19 vaccination among its employees.

State officials say the state of emergency will make home antigen testing free for about 140,000 Vermonters. A spokesperson for the Department of Financial Regulation did not provide an estimate of the number of workers who will not pass the tests covered by their insurance plan.

Some large Vermont employers who run their own insurance plan cover antigen testing, including the University of Vermont Health Network and the National Life Group.

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