What to Know about At-Home Testing for COVID-19
In the early days of the pandemic, testing options were limited to send-out PCR tests, which required laboratory analysis for processing.
While highly accurate, these tests usually require an office visit or a drive-up swab and can take a few days to generate results.
Today, there are a number of different testing options available, including at-home COVID-19 tests that give results in just 15 minutes.
These self-administered tests can be a great way to rule out or confirm a COVID-19 diagnosis and can give you additional peace of mind before returning to work/school or visiting a vulnerable loved one.
What is a self-test for COVID-19?
Unlike many things related to the pandemic, a self-test is as simple as it sounds: it’s a COVID-19 test that you administer on your own, without a medical professional.
The most common self-test for COVID-19 is a rapid antigen test, which is designed to identify if you have COVID-19 and are infectious.
These tests are different from PCR tests, which require laboratory analysis and a day or two’s wait to receive your results.
Self-tests for COVID-19 can be a great way to quickly detect COVID-19 infection, without requiring a trip to your doctor’s office or local testing site.
Are COVID-19 self-tests accurate?
Rapid antigen tests for COVID-19 aren’t as accurate as PCR tests, but they’re still quite accurate.
In fact, a recent study found that rapid antigen tests were 87% accurate in symptomatic patients and 71% accurate in asymptomatic patients.
Rapid tests are particularly good at identifying high levels of the virus – this means they’re a good way to identify individuals who are actively shedding virus and have a higher risk spreading COVID-19.
While false negatives are possible, a false negative likely means that the level of the virus is too low for you to be infectious and risk transmitting the virus to others.
Which COVID-19 self-test should I use?
There are a number of COVID-19 self-tests on the market.
One of the more popular rapid antigen self-tests is the BinaxNOW test from Abbott, which can be used on individuals as young as two years old. The BinaxNOW test offers results in 15 minutes.
Other rapid antigen self-tests include Ellume, QuickVue, InteliSwab, and Flowflex.
Unfortunately, as we’ve seen elsewhere during the pandemic, there are individuals and companies looking to profit from COVID-19 who are offering counterfeit or unauthorized self-tests.
For that reason, it’s best to get your COVID-19 self-tests from a trusted retailer or local organization, not from less regulated sources like Facebook Marketplace or Craigslist.
When purchasing a rapid antigen self-test, it’s important to make sure that the test has received Emergency Use Authorization from the U.S. Food & Drug Administration (FDA).
The FDA website features a searchable list of approved rapid antigen tests on its website.
In addition, every home in the United States is eligible to receive four at-home tests for free from the federal government. You can visit COVIDTests.gov to request your test kit.
Are at-home COVID-19 tests covered by insurance?
Beginning January 15, 2022, private health insurers in the United States are required to cover eight FDA-authorized test kits per covered individual per month.
The experience of getting test kits from a retail store will vary depending on your insurance: some insurers allow patients to get test kits from an approved pharmacy with no upfront expense, while others require patients to submit a receipt and get reimbursed for the cost of the test kits.
Patients should check with their insurer to determine whether the insurer provides direct coverage for test kits (no upfront cost) or if the patient will need to submit a claim for reimbursement.
If you're required to submit a claim, make sure you keep the receipt from your test kit purchase.
CMS.gov offers more detail on the insurance/reimbursement process on its website.
For patients with Medicare, similar coverage of eight test kits per month will begin in early spring, according to the federal government.
Can I get reimbursed for tests I purchased before January 15, 2022?
Once again, it depends on your insurer.
The federal government's coverage mandate doesn't require private insurers to cover tests purchased prior to January 15, 2022.
In many cases, individuals who purchased tests prior to that date will not be reimbursed.
However, some insurers began covering tests prior to that date, so it's worth checking with your insurance provider to verify their policy.
When should I take a COVID-19 self-test?
Consider taking a self-test before spending time with at-risk individuals or, as the CDC recommends, before attending an indoor gathering with individuals who aren’t members of your household.
If possible, you may want to take a self-test after those gatherings as well for additional peace of mind.
Additionally, self-testing is recommended after traveling or after a potential exposure to an individual infected with COVID-19 - even if you’re fully vaccinated.
What should I do if my self-test is positive?
Individuals who get a positive result from a self-test should assume that they are currently infected with COVID-19 and act accordingly.
The CDC's latest guidance (Dec. 27, 2021) recommends that individuals who test positive isolate for five days and wear a mask around others for an additional five days; if you have a fever, stay home until the fever resolves.
It's not necessary to confirm a rapid test result with a PCR test, but you can also consider taking another self-test to confirm the result.
If your kit came with multiple tests you can use another one of those, but may want to try a different brand of test to provide an even means of comparison.
What else should I know?
Keep the following tips in mind to help ensure that you get an accurate result from your self-test:
- Wash your hands thoroughly before conducting the test.
- Carefully read all of the instructions that accompany your test - different brands may require you to take different steps.
- Prior to taking the test, check the expiration date to ensure that the test is still valid.
- Avoid storing your tests in extreme temperatures. The instructions accompanying your test will have further details on the ideal storage conditions.
- Don’t reuse any parts of your test kit, and don’t open the test kit until you’re ready to administer the test.
The CDC also has a helpful video that provides additional tips, as well as an infographic on how to appropriately collect a nasal sample; the infographic is also available in Spanish.