New rule requires insurers to cover OTC home tests

Northern Michigan University student Alexandria Wasinski picks up two KN95 masks from NMU employee Cathy Andrew Friday. NMU is distributing thousands of the masks to students and faculty to try and stop the spread of COVID-19 on campus with in-person classes resuming Tuesday. (Journal photo by Randy Crouch)

MARQUETTE — Gov. Gretchen Whitmer and Michigan Department of Insurance and Financial Services Director Anita Fox are encouraging Michiganders with health insurance to take advantage of a new federal rule that requires health insurers to cover the cost of eight over-the-counter COVID-19 home tests per month, the governor’s office announced on Friday.

As insurers work to implement the new coverage, Michiganders should save receipts and boxes for COVID-19 tests purchased beginning today so they can submit them for future reimbursement, saving a family of four at least $384 a month, the governor’s office said.

“We will continue working with our federal partners to ensure that COVID-19 testing is more accessible and less expensive for every Michigander,” Whitmer said in a statement. “Thanks to this new rule, a family of four, for example, can get 32 tests every month, saving them at least $384 every month. This expanded access to tests will lower costs and help limit the spread of COVID-19.”

Fox said the new health insurance benefit will help reduce barriers to at-home COVID-19 testing for Michiganders.

“Depending on the insurer, consumers may be able to get their covered tests for free at the store or pharmacy, or they may be required to keep receipts for later reimbursement,” Fox said in a statement. “Following the guidance issued Monday by the federal government, insurers have begun developing their plans for offering this new benefit.”

DIFS will compile information from Michigan insurers as it becomes available, and more information will be posted in the coming weeks at Michigan.gov/DIFS, Fox said.

Under the new rule, private insurers will be required to cover up to eight FDA-approved over-the-counter COVID-19 tests per month for each person covered by a health plan, according to the governor’s office. Insurers may, but are not required to, cover tests purchased before today. However, free COVID-19 testing is not limited to Michiganders with private health insurance.

The governor’s office indicated that out-of-pocket costs will vary on on how coverage is provided:

≤ Preferred pharmacies or retailers. If an insurer establishes a network of preferred pharmacies or retailers, individuals can get over-the-counter COVID-19 tests with no up-front costs at those locations. If tests are bought elsewhere, the insurer is required to reimburse up to $12 for those tests.

≤ Reimbursement: If an insurer does not establish a network of preferred pharmacies or retailers, a person will have to pay up front for tests, and the insurer will be required to reimburse the individual for the full purchase price of the covered tests.

≤ Michigan Medicaid and MIChild. These programs provide coverage for at-home tests authorized by the Food and Drug Administration.

People without insurance can get tested for free at some community health centers.

Pilot project started

To help provide additional testing resources to underserved areas of the state, the Michigan Department of Health and Human Services announced it is partnering on a pilot project with libraries across the state to offer free, at-home testing kits.

“We are continuing to find innovative ways to provide Michiganders with opportunities to protect themselves from COVID-19,” MDHHS Director Elizabeth Hertel said in a statement. “Testing is an important tool to limit the spread of the virus and we encourage residents to visit participating library locations to get their test kit.”

This week, nearly 5,500 test kits were shipped to 18 libraries in Calhoun, Clare, Newaygo, Oceana and Saginaw counties and the city of Detroit. Each site received 300 COVID-19 at-home test kits that each include one test, MDHHS said.

Additional kits will be shipped to these sites as needed and more libraries will be added to the distribution in the coming weeks. Information will be posted at Michigan.gov/coronavirus.

Demand for test kits is high across the state and country, especially as Michigan experiences another wave of COVID-19 infections, MDHHS said.

Later this month, all Michiganders will also have access to free at-home tests that will be sent directly to them upon request in the mail by the federal government, the governor’s office said. More information on this new federal program, including a website for making test requests, is expected soon.

North Star moving to virtual

North Star Montessori Academy announced on a Friday Facebook post that the school will move to virtual learning for all students on Tuesday and Wednesday. Monday will remain a scheduled day off.

LMAS issues warning

The Luce-Mackinac-Alger-Schoolcraft District Health Department on Thursday issued a public health warning, noting that COVID-19 cases since Jan. 3 are rising at a rate of 103 every two days in its region.

Omicron, like the variants before it, will create minimal symptoms in some people and others will be very ill or hospitalized, and more will die, it said in a news release.

“What omicron does better than other variants is its ability to infect people, which is why we need everyone to heed this warning,” the health department said.

From March 1, 2020, to Wednesday, the LMAS counties had 5,661 COVID cases and 49 deaths. The 1,343 COVID infections from Dec. 1 to Wednesday represent about 25% of the total cases so far in the pandemic, and the 14 deaths represent nearly 30% of all COVID deaths in the four counties.

LMAS also said the counties are only 59.1% fully vaccinated.

“Although early reports suggest that omicron may not be as deadly as delta, the sheer number of cases will still bring a surge of people needing hospitalization and more deaths,” the health department said.

With cases rising so rapidly, LMAS stressed that it is unable to keep up with the case investigations and contact tracing. Its priorities, it said, are schools, long-term care facilities and other congregate settings.

“You know what to do,” the health department said in in a Wednesday Facebook post. “A vast majority of us have got to work together if we are going to knock this down and save lives and protect each other’s health.”

It urges people to wear a multi-layer mask; two masks; or N95, KN95 and KF94 masks, making sure the mask has no gaps around the sides, chin or nose. Masks work best when worn properly and consistently in public places or any crowded venue, it said.

LMAS also recommended people get vaccinated and receive a booster shot, and stay home if they don’t feel well. Anyone needing to be tested can visit LMASDHD.org for times and locations.

LMAS also announced it now is using a new software program known as PEG, or Patient Education Genius, to help with case investigation.

With cases rapidly increasing in its four counties, LMAS staff, even working at full capacity, are unable to investigate all positive cases in a timely manner, the health department said in a Wednesday Facebook post.

“Now, if you test positive for COVID-19, you may not get a phone call from the health department,” Nicholas Derusha, director and health officer at LMAS, said in the post. “Unless you fall into a high-risk category based on age or type of employment, you will receive a text or email with a link to an online survey. We are asking all residents in our four counties to look for this survey in text or email and fill it out if they receive it after being tested for COVID.”

Derusha said the PEG system is compliant with the Health Insurance Portability and Accountability Act and any information will be viewed only by LMAS investigative staff.

The new survey, which asks about symptoms, onset date of symptoms and close contacts, should take under 15 minutes to complete. LMAS investigators will review the information provided and reach out to symptomatic individuals as needed.

Filling out the online form versus having a lengthy phone call from investigators will be simpler and easier for the public and LMAS staff, the post reads. Residents with questions about COVID-19 can call the state COVID information center at 888-535-6136 or email COVID19@michigan.gov.

Filling out the survey is required for those who want or need an isolation or quarantine letter for their employer. LMAS staff will continue to reach out to individuals with a landline phone.

LMAS suggested that if individuals test positive for COVID-19, they should:

≤ isolate themselves from others.

≤ notify close contacts and encourage them to quarantine, mask and monitor themselves for symptoms.

≤ call a local LMAS office and enter extension 111, or visit https://www.cdc. gov/…/your…/quarantine-isolation.html for more information on what to do if they test positive for COVID-19 or are identified as a close contact.

Aspirus reports on surge

Aspirus Health, based in Wausau, Wisconsin, said researchers continue to gather new information every day on the omicron COVID-19 variant. To date, there seem to be two trends in the data: Omicron is more contagious and its symptoms are less severe.

Aspirus said in a news release that locally, it already is seeing drastic increases in COVID-19 positivity rates. Wisconsin reported a new daily high for the seven-day average of COVID-19 cases on Tuesday, which is now up to 9,696 cases per day with a 28.2% positivity rate. Aspirus processed a system-high of 7,660 COVID-19 tests with a record-high 34% positivity rate from Jan. 2-8.

Aspirus said this is a concern because the highly contagious omicron variant is converging with rising cases of seasonal illnesses like influenza. This dynamic has expanded challenges faced by health systems beyond the hospital to outpatient settings and staffing, it said.

“I would say right now, in part due to COVID hospitalizations and part due to other factors, we’re in a dire state,” said Dr. Steve Phillipson, Aspirus regional director for Hospital Medicine Services, in a news release. “Not just at Aspirus, but throughout the upper Midwest.”

As of Tuesday, 80% of COVID-19 inpatients throughout the Aspirus system were not fully vaccinated, it reported.

“We’re in this situation where we don’t have enough people to take care of people and we don’t have enough beds to take care of them,” Phillipson said. “So, let’s say that you got your vaccine, and your aunt, uncle or grandparent got their vaccine and they got sick with some other problem, we might not have a bed to take care of them.”

To schedule a COVID-19 test with Aspirus Health, use one of the following methods:

≤ MyAspirus App and Patient Portal. Visit myaspirus.org or download the mobile app to access COVID-19 scheduling options. The portal offers the fastest way to get COVID-19 test results. Individuals do not need to be existing Aspirus patients.

≤ Aspirus COVID-19 Call Center Hotline. Call 844-568-0701 or 175-843-1454. The hotline is available from 8 a.m. to 8 p.m. Monday through Friday and 9 a.m. to 6 p.m. Saturday and Sunday. Because the call center is experiencing high call volumes, residents are encouraged to use MyAspirus for scheduling with no wait.

Individuals also may use MyAspirus and the Aspirus COVID-19 Call Center Hotline to schedule an appointment for the COVID-19 vaccination.

Christie Mastric can be reached at 906-228-2500, ext. 250. Her email address is cbleck@miningjournal.net.


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