January 20, 2022

Gillibrand Leads Colleagues In Push To Expand TRICARE Coverage Of At-Home Covid-19 Tests For Service Members And Their Families

Letter to DoD Says TRICARE Coverage Should Follow Same Requirements as Biden Administration is Requiring For Those Covered Under Private Insurance

Today, U.S. Senator Kirsten Gillibrand (D-NY), chair of the Senate Armed Services Personnel Subcommittee, is announcing her push to expand TRICARE coverage of at-home COVID-19 tests for service members and their families. Currently, TRICARE beneficiaries can only receive coverage for at-home tests if they have an order or referral from a TRICARE-authorized provider. In a letter to Secretary of Defense Lloyd J. Austin III and Deputy Assistant Secretary of Defense Dr. David J. Smith, Gillibrand calls for TRICARE coverage to follow the same requirements as the Biden administration requires for those covered under private insurance.

TRICARE is authorized to cover at-home tests if they are determined to be medically necessary. The Families First Coronavirus Response Act (FFCRA; P.L. 116-127) included provisions from the Free COVID-19 Testing Act, a bill introduced in March 2020 to protect all Americans from charges for COVID-19 tests, and requires that TRICARE cover COVID testing with no cost-sharing requirements. Recent guidance by the Centers for Disease Control and Prevention (CDC) demonstrates that home tests are medically necessary.

“Right now, 9.6 million TRICARE beneficiaries are struggling to access at-home COVID-19 testing,” said Senator Gillibrand. “As we continue battling this pandemic, it’s common sense to increase access to COVID-19 resources and expand TRICARE coverage for at-home tests without requiring a formal referral process. I’m urging Secretary of Defense Austin and Deputy Assistant Secretary Smith to protect our service members and swiftly expand coverage for TRICARE beneficiaries.” 

This letter is co-signed by Senators Mazie Hirono (D-HI), Elizabeth Warren (D-MA), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Tina Smith (D-MN), Mark Kelly (D-AZ), Cory Booker (D-NJ), and Michael Bennet (D-CO). 

For the full text of the letter, please click here and see below.

 

Dear Secretary of Defense Lloyd J. Austin III and Deputy Assistant Secretary of Defense Dr. David J. Smith:

Thank you for everything that you have done to protect servicemembers, military retirees, and their families from the pandemic. The ability for all Americans to test for COVID-19 could not be more critical in light of the amplified transmissibility of the Omicron variant that accounts for over 90% of new cases in the United States. Beginning on January 15, 2022, the Biden-Harris Administration will require insurance companies and group health plans to cover eight at-home COVID-19 tests (i.e., over-the-counter-, self-, antigen-, nucleic acid amplification-, at-home-, or point-of-care-test) per month and per individual.

Currently, TRICARE beneficiaries can only receive coverage for at-home COVID-19 tests if it’s medically necessary as determined by a TRICARE-authorized provider, meaning they must have an order or referral for the test for it to be covered. 

We write to urge the Department of Defense to expand TRICARE coverage to include at-home tests under the same requirements as the Biden Administration is requiring for those covered under private insurance. Under the Families First Coronavirus Response Act (FFCRA; P.L. 116- 127), TRICARE is required to cover COVID testing with no cost-sharing requirements for the duration of the Public Health Emergency. Under law, 10 USC Sec 1079(a)(13), TRICARE is directed to cover “medically necessary services and supplies required in the diagnosis and treatment of illness or injury.” The recent guidance by the Centers for Disease Control and Prevention (CDC) demonstrates that home tests are medically necessary. It states, “self-tests can also be used as one of many risk-reduction measures, along with vaccination, masking, and physical distancing, that protect you and others by reducing the chance of viral transmission.”

It is critical that the 9.6 million TRICARE beneficiaries have access to at-home tests to keep them and their communities safe. We urge you to expand TRICARE coverage, under your current authority, so that those who are serving and have served our country receive the same protections as other Americans. With the rapid rise in COVID-19 cases due to the surge of the Omicron variant, it is imperative that this change is made immediately. Thank you for your consideration. 

Sincerely,