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At-Home COVID-19 Tests: Options and How To Choose

At-home COVID-19 test options are currently limited to molecular/PCR tests, but antigen/rapid tests may be available for at-home use soon for those looking to screen for coronavirus symptoms.

By: Chris Riley

Medically reviewed by: Dr. Gerardo Sison

Last Updated: April 5th, 2021

Since the first case of COVID-19 was diagnosed in December 2019, the virus has spread around the world, affecting more than 127 million people around the world and over 30 million people in the United States alone. 

While social distancing, wearing masks, and practicing good handwashing and hygiene techniques are important to public health and safety, sometimes people can be exposed to the coronavirus no matter how many precautions are taken. 

If you have developed symptoms of COVID-19, been exposed to the virus, or experienced a need to travel, you may have tried to access a COVID-19 test with little success. Test availability has been problematic throughout the pandemic, and while availability has increased, many people still have trouble getting tested. Without test results, the virus will continue to spread. 

Recognizing this difficulty, numerous companies have developed at-home COVID-19 tests that can help detect the virus before you infect someone else. However, not all at-home COVID-19 tests are created equal, and there are many different options. Here’s how to choose.

Types of COVID-19 Tests

There are currently three different types of COVID-19 tests, including molecular, antigen, and antibody tests. Of these types, only molecular tests are currently available for sale for at-home use; however, antigen tests may soon become available.

Molecular

Molecular COVID-19 testing is a type of test that most people are familiar with. Molecular tests sometimes referred to as polymerase chain reaction, or PCR tests, require a nasal swab or saliva sample to detect the presence of the COVID virus. This type of test looks at the genetic material in the sample and amplifies it to determine if COVID is present. 

The results from a molecular test typically take two to three days to process, depending on the demand at the laboratory. Molecular tests are currently the only type of at-home COVID-19 test that is available for retail sale. All other tests require emergency use authorization. 

Antigen

Antigen tests are commonly known as rapid tests and work by detecting the presence of virus proteins on the surface of a sample. Antigen tests work quickly to provide results, which are typically available in about 15 minutes, but they are notoriously less reliable than molecular tests, particularly for individuals who are carrying the virus but do not have any symptoms, such as loss of taste or shortness of breath. 

The antigen test is associated with a higher rate of false negatives than the molecular or antibody tests. Several at-home antigen tests have been authorized for use by the FDA; however, these tests have not yet been made available for sale, therefore there are currently more limited testing options. 

In general, antigen tests are very specific for COVID-19, but are not as sensitive as molecular PCR tests. This means that there is a higher chance of false negatives than with many molecular tests.

Antibody

Antibody tests use a blood sample to determine if your body has developed antibodies to COVID-19, which indicates a previous infection or vaccination. People who suspect that they may have had coronavirus symptoms early in the pandemic, before testing was widely available, may benefit from an antibody test to determine if they have had previous exposure to the virus. 

Because antibody testing requires a blood sample, they are only available in a doctor’s office or laboratory setting. Additionally, because these results must be processed in a lab, they typically take several business days to be processed. 

Benefits of At-Home COVID-19 Tests

There are many benefits of at-home COVID-19 tests, but arguably the biggest benefit is accessibility. Most people will remember that early on in the pandemic, it was difficult, if not impossible, to get access to a COVID-19 test. The only exception would have been if you had severe symptoms of COVID-19, and even then, availability was limited. 

While one might think that this problem has abated now that the pandemic has been a major issue for over a year. According to the health department, studies show that one in four Americans still have not been able to get a coronavirus test when they wanted one. 

Common reasons cited for difficulty in obtaining a test include the wait at the testing site being too long, difficulty traveling to the testing site, or being unsure about when testing was available. 

At-home test kits eliminate all of these issues by delivering all of the supplies you need to test directly to your home, including a prepaid shipping envelope. Patients receive their results electronically.

Disadvantages of At-Home COVID-19 Tests

Although at-home COVID-19 tests are much more convenient than in-person testing and are much more accessible, there are some disadvantages associated with this type of testing. 

First, as noted above, there are fewer options available for at-home COVID-19 tests in terms of the types of tests that you can take; currently, only molecular/PCR tests are available from home. That means that if you’re hoping to receive rapid results or you want to test for previous COVID-19 infection from the virus, an at-home COVID-19 test won’t work for you.

Second, people who have symptoms of COVID-19 or known exposure to the virus are often able to get the test done for free in a doctor’s office or other clinical setting. While some companies do offer the test for free with insurance coverage from your healthcare provider, other at-home COVID-19 test companies offer an itemized receipt for possible insurance reimbursement or may provide the option to use your FSA or HSA, and others require up-front payment. People who do not have access to health insurance or are underinsured may end up paying considerably more for their test than people who are able to travel to an in-person location for the test. 

Third, in regards to testing options, at-home COVID-19 tests can be less accurate than tests conducted in clinical or laboratory settings due to the potential errors that can occur when gathering sample collections on your own. Workers in clinical settings are specially trained to collect the sample properly to ensure an accurate result as often as possible. However, home collection kits that are not handled correctly have the likelihood to produce a false negative result.

How To Choose an At-Home COVID-19 Test

When choosing an at-home COVID-19 test, there are a few factors to consider. 

First, you’ll want to ensure that the test you choose is FDA-approved for testing for the presence of a COVID-19 infection. If a company refers to the test as using “FDA-approved technology” rather than stating outright that the test itself is FDA-approved, they might be offering an ineffective test.

Second, look for companies that use certified laboratories to process your sample. Look for terms like “CLIA-certified laboratory” or “CAP-accredited laboratory,” as these designations indicate that the laboratory has passed certain rigorous tests to ensure the quality and accuracy of its product.

Third, look at what type of sample is required for the coronavirus test. Some tests require only a nasal swab, while others require only saliva, and some require both. Choose the type of test that requires a sample that you feel confident in collecting on your own.

Finally, look at the payment types accepted by the company. Some companies are able to process the test through your health insurance, while others allow you to use HSA/FSA funds, and others require payment up front. Some companies allow payment with PayPal, while others require the use of a major credit card. Choose the company that makes the most sense for your financial situation.

Options for At-Home COVID-19 Tests

Everlywell

People who are nervous about choosing an at-home COVID-19 test that requires a nasal swab don’t need to be afraid of the test offered by Everlywell. Everlywell offers an at-home COVID-19 test that requires just a shallow swab test from the inside of the nostrils and is much more comfortable. 

Everlywell accepts payment for the $109 cost in the form of major credit cards and FSA/HSA cards and will also provide you with an itemized receipt so that you can request reimbursement with your healthcare provider if you choose to do so. 

Everlywell’s lab only operates Monday through Saturday, so make sure you send your sample back on a weekday for the fastest results. Results are typically available within 24 to 48 hours.

Vitagene

People who are uncomfortable with the idea of using a nasal swab at all can choose to take the at-home COVID-19 test from Vitagene. The company is the first to offer an at-home COVID-19 test that can be processed with only a saliva sample. Results are available within 72 hours of the sample being received by the lab. 

The test costs $117 and can be paid for out of pocket or with your HSA/FSA card; FedEx overnight shipping to the laboratory is included. You may be eligible for insurance coverage if the test is prescribed by a doctor; however, Vitagene does not process insurance claims so it will be up to you to contact your healthcare provider.

Pixel by LabCorp

Pixel by LabCorp offers an at-home COVID-19 test that is free if you are experiencing symptoms of COVID-19, have experienced known exposure to someone who has tested positive for COVID-19, or live in a group setting, such as a nursing home or college dorm. 

Pixel by LabCorp will bill your insurance for the cost of the test if you have commercial health insurance and will access federal funds for the test on your behalf if you are uninsured. 

People who do not meet any of the above criteria can purchase the test for $119. The sample is collected via nasal swab, the lab processes samples seven days per week. You’ll receive your results within one to two days of your sample arriving at the laboratory. 

DxTerity

If you’d prefer to order your COVID-19 test using your Amazon account or simply want the peace of mind that comes with knowing that your express return shipping is prepaid, the DxTerity test might be right for you. 

After purchasing the test through Amazon, patients will need to visit the DxTerity website to register their kit and answer a questionnaire. Amazon processes FSA/HSA payment for the test, as well as out of pocket payments, and DxTerity offers insurance reimbursement information on their website. Patients need only to submit a saliva sample, and return shipping for sending the sample to the lab is prepaid. 

Hims

Patients who are currently experiencing COVID-19 symptoms have the option of using the at-home COVID-19 test kit from Hims. Included in the 150 dollar price is a medical consultation, test kit, and prepaid expedited shipping. The results are available about three to five days after the sample is received by the lab. 

The saliva-based test makes for easy sample collection and is ideal for people who prefer to avoid nasal swabs. However, the test is not appropriate for patients who do not have symptoms of COVID-19 and may provide a false negative for patients who are symptomatic. 

To ensure that the test is right for you, Hims includes a medical consultation prior to paying for the test, so you don’t have to worry about wasting your money.

Summary

Receiving access to COVID-19 tests has been a problem throughout the pandemic, and while testing is much more available today than it was a year ago, accessibility issues remain. People who do not have time to wait in line for a test, do not have transportation available to get to the test site, or who simply prefer the convenience of testing at home have lots of options when it comes to at-home testing. 

Consumers should consider the accreditation of the test itself and the facility, as well as the type of sample required and the way payment is processed, before choosing an at-home COVID-19 test. 

While molecular/PCR tests are currently the only type of COVID-19 test that is available from home, several antigen tests have been approved for emergency use by the FDA and may be available for sale in the near future. Antibody tests, which require a blood sample, are not expected to be available for at-home use.

Sources:

https://www.statnews.com/pharmalot/2021/02/15/stat-harris-poll-1-in-4-americans-unable-to-get-covid19-test/ 

https://www.cdc.gov/coronavirus/2019-ncov/index.html 

https://www.health.com/condition/infectious-diseases/coronavirus/covid-19-test-type