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Vermont’s rollout of no-cost antigen tests causes some confusion

Published: Dec. 20, 2021 at 4:54 PM EST|Updated: Dec. 20, 2021 at 6:40 PM EST
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MONTPELIER, Vt. (WCAX) - Two weeks in and it’s an uphill battle to implement a plan for free or reimbursed rapid antigen tests for thousands of Vermonters.

Some 240,000 Vermonters are covered by two separate rule changes earlier this month. But supply chain issues are still posing a challenge, as many pharmacies are not able to track down tests.

Under two emergency rules issued two weeks ago, those 240,000 Vermonters are eligible for up to eight free or reimbursed antigen test kits a month. State leaders say the rule change is aimed at breaking down cost barriers to obtaining antigen tests.

Vermont Medicaid, the Vermont Education Health Initiative as well as Blue Cross Blue Shield of Vermont, Cigna and MVP Healthcare are covered. But not all of their plans are. That’s because some of those companies have plans regulated by the federal government, so they don’t have to follow this state rule. To add to the confusion, not every test is covered either. So even if your insurance plan covers antigen testing, you could buy an antigen test not included in Vermont’s rule.

State leaders say before you head to the pharmacy, check with your insurance company to see if your plan covers that brand of test.

“It is a little bit of a maze to navigate but we want to make sure that those who are covered, about 240,000 Vermonters, that they’re aware they have the coverage and that they can seek the tests without the financial barriers,” said Michael Pieciak, the commissioner of the Vermont Department of Financial Regulation.

With Christmas and the new year just days away, many are seeking antigen tests so people can gather safely. But a big challenge here is actually finding the tests, too. Many shelves in pharmacies are cleaned out due to supply chain issues.

The state is working on securing thousands more antigen tests. But they say more help from the federal government is needed to unblock the supply chain and get tests to pharmacies and state governments.

“The supply does need to increase,” Pieciak said. “The demand for them has shot up as we get closer to the holidays so that even with increases in the supply chain that have been happening in the last few weeks it has not been able to keep up with the demand.

Leaders are also encouraging people to seek antigen tests online as well. According to Pieciak, there are around 40 FDA-approved antigen tests, and you can get reimbursed after your purchase through your insurance company. And there’s always free PCR testing administered through the state, as well.

So what happens if someone’s insurance plan covers the antigen test they want and they have to pay out of pocket? Eligible Vermonters’ expenses will be backdated to Dec. 1. So leaders say it’s important that you hold onto your receipts if you do pay out of pocket.

State officials say they’re still working to educate and inform pharmacies, insurance companies and Vermonters about the program.

The Biden administration is expected to announce a similar rule change next month, and it’s expected to cover Medicare patients. But there are still unknowns about exactly who it will cover and how it will be rolled out.

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