As the US Awaits Pfizer’s Omicron Vaccine, Biden Administration Gets At-Home COVID Tests Privately Insured

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In the midst of an Omicron surge that is triggering scores of school closings and strained hospitals due to staff shortages and increased hospitalizations throughout the country, the White House detailed its plans to mandate insurance companies to reimburse the purchases of at-home COVID-19 tests.

In addition, Pfizer CEO Albert Bourla announced on Jan. 10 that the pharmaceutical company is set to launch a redesigned COVID-19 vaccine that targets the Omicron variant of the virus by March, according to reports.

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Beginning Jan. 15, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance, according to an administration statement.

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Insurance companies and health plans are required to cover eight free over-the-counter at-home tests per covered individual per month. In addition, there is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.

“Under President Biden’s leadership, we are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost,” Health and Human Services Department Secretary Xavier Becerra, said in the statement. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also purchasing half a billion at-home, rapid tests to send for free to Americans who need them. By requiring private health plans to cover people’s at-home tests, we are further expanding Americans’ ability to get tests for free when they need them.”

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The administration said that when plans and insurers make tests available for upfront coverage through preferred pharmacies or retailers, they are still required to reimburse tests purchased by consumers outside of that network, at a rate of up to $12 per individual test.

“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated. Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people,” said Centers for Medicare & Medicaid Service Administrator Chiquita Brooks-LaSure.

Meanwhile, Albert Bourla, Pfizer CEO speaking at the J.P. Morgan Healthcare Conference Jan. 10, said that Monday the pharmaceutical company and its partner BioNTech already had started manufacturing a version of the vaccine that would target both the fast-spreading Omicron strain as well as the original COVID-19 strain, Barron’s reports.

“We will have not only data, but I think we will be ready almost to go, file and launch if it’s successful and if we need the demand,” Bourla said, according to Barron’s.

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“The hope is that we will achieve something that will have way, way better protection particularly against infections, because the protection against the hospitalizations and the severe disease — it is reasonable right now, with the current vaccines as long as you are having let’s say the third dose,” Bourla added on CNBC.

Keith Speights, Motley Fool contributor told GOBankingRates that it’s not surprising that Pfizer CEO Albert Bourla told CNBC on Monday that his company would have a vaccine targeting the Omicron variant ready by March.

“Pfizer has been saying this since early last month. What is perhaps surprising, though, is that the rapid development of a new vaccine version is having minimal impact on Pfizer stock — especially considering the surge in COVID-19 cases due to Omicron,” Speights said.

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“The problem is that Pfizer could be late to the party. By the time the company’s omicron-targeted vaccine is available, the current wave of COVID-19 cases will likely be largely over. However, Pfizer’s efforts could pay off for investors down the road. It’s possible that the immunity against Omicron from natural infection and current vaccines could wane quickly. If so, omicron-specific boosters could be in demand in the future,” he added.

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Article edited to add quote from Keith Speights.