New Report Shows Free Access to COVID Home Tests Works, Yet Some Still Face Challenges

Most people who knew about the right-to-access received free tests, but too many remain unaware about program and that the benefit ends soon

(Berkeley, CA) Today, Safely Opening Schools (SOS), a project of the Public Health Institute—in consultation with the California Department of Public Health—released a “Secret Shopper Report” that analyzes the effectiveness of the January 2022 federal emergency measure requiring health insurers to provide up to 8 free COVID-19 home tests a month for insured Californians. The report assessed the ease, or difficulty, faced by “Secret Shoppers” in attaining free tests based on their insurance provider and the pharmacy visited. Notably, nearly 80% of visits to pharmacies resulted in successfully accessing tests using insurance, without any upfront costs. 

SOS Secret Shoppers (including high school students) in nine counties across California used a myriad of insurance policies to test accessibility to free COVID tests. They made 479 pharmacy visits in January – March 2023 and spoke with pharmacy staff at both the front check-out counter and the pharmacy window.

Key findings include:

• It works—if you know your rights. Eight of 10 (79.5%) visits by Secret Shoppers resulted in successfully obtaining tests using insurance with no upfront payment; this reflects a 94% success rate at Kaiser Permanente pharmacies, 80% in chains and 66.7% at independent pharmacies. The overwhelming majority of Secret Shoppers (and their families) were previously unaware of both the opportunity to collect free COVID tests and that it ends soon for many.
• Public insurance worked best. Public plans (mostly Medi-Cal) covered the tests with no upfront cost (84.4% of visits). Private insurance did so 73% of the time, but varied widely among providers from (36.4%–100%). 
• Pharmacy and insurer shortcomings: In only 8.6% of pharmacy visits was there posted signage about the free COVID tests in English (and 4.6% in other languages). In one in five visits, shoppers failed to obtain any free tests – typically due to tests being out of stock or requiring upfront payments. In less than half of these unsuccessful visits (41%), pharmacy staff explained how to get reimbursed when free COVID tests were denied using insurance upfront.

The overwhelming majority of Secret Shoppers and their families were unaware of their eligibility for free COVID tests. 

The report comes at a critical moment and offers an important public health service:

• This free program is set to end for traditional Medicare fee-for-service recipients on May 11th, and for most of those privately insured, on November 11th. (Medi-Cal will continue offering it.) Medicare Advantage plans and some other private plans may vary after May 11. 
• The value of 8 free tests is close to $100.00 (a month) per person—a valuable benefit for lower income and especially vulnerable populations. 
• COVID continues to take a steep toll on the health and well-being of Californians. Over the first few months of 2023, California suffered on average 1,342 new COVID cases and approximately 18 deaths per day, and between 2,000 – 4000 hospitalizations a week. 
• Testing remains an essential tool to protect the health and safety of children and families, and to inform decisions for those in more at-risk groups—like older people, those with certain medical conditions, and the unvaccinated—so they can determine whether to use Paxlovid early or other medicines.  

Report recommendations include:

• For Families: Families should stock up NOW on free tests, while available, for the coming year and check with their insurer about coverage after May 11. People can get up to 8 tests per person every 30 days. Families whose Medi-Cal coverage may be expiring with the end of the emergency should take immediate action to ensure it’s renewed;
• For Improving Program Effectiveness: All parties—government, (including public health agencies), healthcare providers, insurers, employers, schools, and pharmacies—should work together to proactively educate consumers about the program and the remaining availability of this benefit;
• For Pharmacies: Pharmacies should more actively and effectively communicate access to free tests through insurance using prominent store signage and shelf prompts where they stock tests, sign up with insurers to provide tests for free with no upfront costs, and always keep tests fully stocked;
• For Government: Given the confusion of disparate program deadlines, government should continue to communicate to the public about their right to free tests and consider a uniform extension of required coverage of free COVID tests by all insurance;
• For Insurers: Insurers should voluntarily maintain coverage (where not already required) for this important benefit to help with earlier diagnosis and treatment and to reduce spread of COVID, and use contracts with pharmacies that allow for dispensing without upfront costs.

“COVID is still costing Californians a high price in lives lost, hospital visits, and days too-sick to work,” reflected Samar Hadrous, Associate Testing Strategist with SOS. “This policy provides an enormous opportunity for people to protect their health and the health of those they love. We strongly urge families to stock up on free tests now, while this benefit is still offered.”