The number of reported COVID-19 cases in Massachusetts and the virus levels in wastewater continue to creep up as many people get ready to visit family for Mother's Day weekend.

To avoid spreading the virus — especially to people considered at high-risk of severe disease — health experts are advising people to take rapid antigen tests. And those tests, which had previously been expensive and hard to come by, are now more available than ever.

Most Massachusetts residents can show their insurance card to get free rapid antigen tests at the pharmacy desk of stores like CVS and Walgreen's. Each insured person is eligible to get up to eight free tests each month, so a parent could obtain eight free tests for themselves and another eight for their child, as long as they provide both insurance cards.

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In January, the federal government required health plans to reimburse their members for buying rapid tests. People could purchase the tests out-of-pocket, then submit receipts to get paid back by their insurer. Some insurance companies have been taking orders for tests on their websites and mailing them out to members.

In recent months, in a shift that's making rapid tests more broadly accessible, major pharmacies have begun offering the tests for free by processing them just like any other prescription.

"Gathering the receipts and sending them constitutes its own barrier," said Stephen Kissler of the Harvard TH Chan School of Public Health. "But if you can go to the pharmacy and pick them up using your insurance card right there on the spot, that's really helpful."

That free availability at pharmacies doesn't seem to be widely known. Even Kissler, who studies the effectiveness of rapid antigen tests, wasn't aware they could be picked up that way until GBH News asked him about it.

The federal rule in January said prescription coverage in medical insurance plans should cover the cost of up to eight rapid antigen tests per person each month, although some stores are limiting customers to six tests. For Massachusetts consumers, that level of prescription coverage is required to meet federal and state minimum coverage mandates.

Massachusetts leads the nation with 97 percent of people having medical insurance, so this rule will broadly increase access across the commonwealth.

According to the state's office of Health and Human Resources, the tests should be available for free at pharmacies for people with coverage through MassHealth, which covers both Medicare and Medicaid recipients in the state.

The Massachusetts Association of Health plans says all of its member insurance companies allow consumers to get rapid tests for free by showing their insurance card.

"They worked with their preferred pharmacy partners to develop networks where their members could go and, at the point of sale, receive up to eight at home COVID-19 tests without having to pay upfront costs at the time of purchase," said Elizabeth Leahy of MAHP.

It doesn't always work at the pharmacy counter. While all health plans are federally mandated to reimburse for rapid tests, some consumers shared with GBH News that they have been rejected when trying to get tests without an initial, up-front payment.

"Folks should contact their insurer to confirm that you're eligible for this benefit," Leahy said.

The state says there are options for uninsured people to get free tests, too. The office of Health and Human Services said that since January, they've distributed more than 10 million at-home tests to schools, shelters, community centers and other locations. Another million tests were recently distributed through local food banks.
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Check your coverage

You can contact the member services phone number on your insurance card or visit your insurer's website: Allways Health Partners, Aetna, BMC HealthNet Plan, Blue Cross and Blue Shield of MA, Cigna, ConnectiCare of Massachusetts, Fallon Health, Harvard Pilgrim Health Care, Health New England, Tufts Health Plan or UnitedHealthcare Insurance Company.
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Even if they're more able to get rapid tests now, many people continue to be confused about when it's best to use them and what exactly the test results mean.

Stephen Kissler of Harvard said there are two times he finds rapid tests to be most useful.

"The first is if I'm about to go see someone who might be high risk," Kissler said. "So if I'm about to see an older relative or somebody with some co-morbidities that would make it bad if they were to get COVID, I usually take test before going to see them."

The second time he'll take a test, Kissler said, is if he has symptoms like a cough, or if he's been exposed to someone who had COVID-19.

"Usually I'll wait a couple of days, try to reduce how many encounters I have with people outside my household, and then take a rapid test — sometimes two — to essentially clear myself for more regular day-to-day contact," he said.

The key piece of information a rapid test tells you, Kissler said, is whether you're contagious at that moment, so it's best to take the test right before you make a visit to an older or immune-compromised loved one. And people should note, he said, that because it can take several days after exposure to become contagious, someone who tests negative today can become contagious — and test positive — tomorrow.

"A rapid antigen test is the best tool we have to tell me how I should behave," Kissler said.

PCR tests, which are conducted in a lab and are considered the gold standard, tell people if they've had COVID-19, but not whether they're still infectious.

"I know [from a PCR test] that I've been infected with SARS-CoV-2 at some point in the recent past, but it actually doesn't give me all that much information about what I now need to do," Kissler said. "The nice thing about rapid antigen tests is that they tell me within minutes a very good picture of whether or not I am a risk of infection to people around me. And to me, that's hugely valuable."