有人试过去保险申请报销回国检测的费用吗?

exactly。

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您贴的这个FAQ的时间在2021拜登总统令之前,不relevant,已经是前朝的policy了,当时确实是不cover的。

你贴的文件里的:

Q2. May plans and issuers distinguish between COVID-19 diagnostic testing of asymptomatic people that must be covered, and testing for general workplace health and safety, for public health surveillance, or for other purposes not primarily intended for individualized diagnosis or treatment of COVID-19?
Yes. Plans and issuers must provide coverage without imposing any cost-sharing requirements (including deductibles, copayments, and coinsurance), prior authorization, or other medical management requirements for COVID-19 diagnostic testing of asymptomatic individuals when the purpose of the testing is for individualized diagnosis or treatment of COVID-19. However, plans and issuers are not required to provide coverage of testing such as for public health surveillance or employment purposes. But there is also no prohibition or limitation on plans and issuers providing coverage for such tests. Plans and issuers are encouraged to ensure communications about the circumstances in which testing is covered are clear. To the extent not inconsistent with the FFCRA’s prohibition on medical management, plans and issuers may continue to employ programs designed to detect and address fraud and abuse

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那我明确地告诉你,保险公司拒绝我两层appeal,我上诉到州保险监管机构,州监管机构把case转给保险公司。保险公司来函表示经过仔细研究法律,确实原来的审查员犯了错误,会加强培训,并重新批准了报销申请,州监管机构在复函中更明确表示,经过审查,同意保险公司的意见。当然您继续认为保险公司向州监管机构作出上述表态是为了降低法律成本,我也没有意见,毕竟我理解保险公司在收到州监管机构转去的case的时候,say no的成本应该更低才对,因为可以完全依赖之前的文书,而不需要重新起草复函。

此外,我对于您将成功获赔的案例诬为“骗保”或者“利用漏洞”我绝对不能接受。我成功获赔的案例是得到保险公司自认、州监管机构背书的,保险合同作为民事合同本来就是双方满意即可,更何况经过了州监管机构审查,完全遵照正当程序,难道您对法律的个人理解就超过了州监管机构?好吧,反正也许您会进一步认为法官判的案子也未必符合法律。

回答网友的为什么没有检测机构打广告问题,因为be in network就要接受保险公司的监管呀,所以他们当然remain out of network。再者说,如果告诉了测试群众他们可以报保险,一些不法定点机构如何double billing?

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大部分公司就是不想去deal这么麻烦的东西。就连医生,比如一个保险deny了他们的claim,他们也会不愿意deal这种反反复复的东西来停止索要,未来尽量少收这类病人就好了。US healthcare admin cost大概占15-30% total healthcare spending,差不多是癌症治疗支出2-3倍。这可是David Culter在congressional testify时候说的。

不过这东西没必要纠结想去了。想去反复argue走灰色地带就可以自己可以back and forth试几次,反正最后一都是提高自己pool里面的utilization,来年保费均摊后顶多有个小幅上涨。我自己没有也不会去claim。只是想给大家讲明白,大家自己去决定走不走。类似的操作还有self employee常见“省税”灰色地带做法,做不做是个人选择。

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不知道学校的保险能不能网开一面cover这些

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同问,毕竟留学生保险真的贵的一比

如果不是寻求报销,而是花自己HSA里的钱,有没有明文规定?

嗯,我做测试之前特地打电话给我保险公司确认,如果身体健康只是需要测试为旅游做准备不是免费,只有有症状以健康为理由的测试才是免费;保险公司会根据你约appointment时的选择题答案来决定全付还是我要付部分;我朋友的保险就是不问理由都是免费,所以是看保险公司的条款