The appeal of at-home COVID tests is obvious (what a time saver!), but are they accurate? Learn more about how these at-home COVID-19 tests work, what they cost, and some of the best available kits.

By Brittany Loggins
Updated April 02, 2021
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If you're looking to get tested for COVID-19, the draw of taking an at-home test is obvious. You can save time and avoid coming into contact with someone who might be infected. Pretty ideal.

Even better, at-home COVID-19 tests are likely to be highly accurate, says Alexander J. McAdam, M.D., Ph.D., medical director of the Infectious Diseases Diagnostic Division at Boston Children's Hospital and associate professor of pathology at Harvard Medical School.

Most at-home tests that people have been talking about are RT-PCR or molecular tests, which "work by using chemical reactions that make many, many copies of the viral genome, and detecting those copies," explains Dr. McAdam. Once a lab technician receives a specimen (usually, mucus from the throat or nose), they use a chemical to extract genetic material from any virus on the swab, according to the Food and Drug Administration (FDA). They then use a machine to detect whether COVID-19 is present; the machine indicates a "positive" or "negative" result, accordingly. (Related: Everything You Need to Know About Coronavirus Testing)

RT-PCR tests are "highly sensitive," which means that they are capable of detecting the virus in both symptomatic and asymptomatic people, says Dr. McAdam. They're also "highly specific, meaning they will not give false-positive results in samples that do not contain SARS-CoV-2," he says. In fact, the FDA describes RT-PCR tests as "typically highly accurate and usually does not need to be repeated" versus antigen tests, another commonly used type of coronavirus test that is more likely to produce false-negative results, according to the FDA.

While at-home COVID-19 tests are convenient and likely accurate, they do have their drawbacks. For one, they have a triple-digit price tag compared to in-office testing which is always free regardless of whether you're insured. That said, if you have insurance, your plan should reimburse at least a portion, if not the full price, of your purchase of an at-home COVID-19 test. For example, Aetna says that it will cover diagnostic (molecular PCR or antigen) tests, including those that are "direct-to-consumer/home-based."

However, as the pandemic evolves and eventually comes to an end with the help of COVID vaccines, this could change. For example, United Health Care currently reports that "during the national public health emergency period, currently scheduled to end April 20, 2021," members will not have to pay for COVID-19 testing when "ordered by a physician or health care professional for purposes of diagnosis or treatment." Federal legislation now requires private health insurance plans to cover the cost of at-home tests when they're deemed medically appropriate by a health care provider. Meaning, as long as a doctor prescribes the test, your health insurance is required to cover the cost in its entirety. Depending on which at-home COVID-19 test you choose, the test-maker can bill your insurance directly or you might have to pay upfront and submit your itemized receipt to get reimbursed by your insurance.

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How you get your hands on an at-home coronavirus test depends on which test you're after, your current state of insurance, and medical eligibility.

At-home COVID-19 tests collect either saliva or mucus (via nasal swabs). The saliva option (such as For Hims & Hers Saliva Test Kit) simply involves gathering enough spit to fill a test tube to a certain level. To collect a mucus sample, you'll typically have to swab the lower cavity of your nose with the super long Q-tip until you feel resistance. Specifics on how deep to insert the nasal swab, how long to keep it in your nose, etc. are provided by the at-home coronavirus test brand, so be sure to read and follow the instructions carefully.

Once your sample is collected, you place it in the provided biohazard bag and send it to the lab via an included return label. (Related: When Will a COVID-19 Vaccine Be Available — and Who Will Get It First?)

As of now, in most cases, you'll still have to send your at-home COVID-19 test sample off to a laboratory where the testing is performed. "There is a lot of discussion about true home tests that would provide a rapid result in the home or wherever the test is done," says Dr. McAdam. "But I don't know that these are available yet." Turns out, they might be soon: The first rapid at-home COVID-19 test — Lucira COVID-19 All-In-One Test Kit — received emergency use authorization (EUA) from the FDA in November. Even more recently, the FDA granted EUA to the Ellume COVID-19 test, the first home COVID-19 test that won't require a lab or prescription.

In the meantime, if you're considering taking an at-home test, here are some of the best options available right now or on the horizon.

Pixel by LabCorp COVID-19 Test

One of the first at-home coronavirus tests to receive EUA from the FDA, the Pixel by LabCorp COVID-19 test is HSA- and FSA- eligible, and costs $119. Otherwise, LabCorp can bill your insurance or use federal funds to cover the cost if you're uninsured. (Related: Why You Might Be Feeling Socially Anxious Coming Out of Quarantine)

Currently, the tests are reserved for those who are experiencing symptoms, have been exposed to someone with COVID-19, or have been recommended by a health care provider, public health department, or contact investigator. You'll respond to an eligibility questionnaire, and if you meet the qualifications, you can order the test online immediately. (FWIW, LabCorp just announced that it's the first company to receive FDA EUA to sell the kit in retail locations without requiring a prescription, which means you could soon get a test if you didn't meet the current qualifications.)

If you place your order before 3 p.m. ET, it'll probably arrive the next business day; otherwise, it'll probably arrive in two business days, according to the company's website. The sample collection kit includes a nasal swab and packaging information so that you can return the test. After you send your sample back with a prepaid label, it will take one to two days for you to get results, which you can see online.

Everlywell COVID-19 Test Home Collection Kit

The Everlywell COVID-19 Test Home Collection Kit is similar to the LabCorp test in that it's received FDA EUA, it's reimbursable via insurance, and it's FSA- and HSA-eligible. Another similarity is that you'll have to take an eligibility survey before you can order the test, but if you qualify, you can immediately order it. The out-of-pocket cost is $109, and Everlywell can't bill your insurance directly, so if you want your insurance to cover the cost, you'll have to pay upfront then request a reimbursement. (Everylwell provides a step-by-step on how to file for reimbursement.)

You'll typically get the at-home COVID-19 test within one to five business days upon ordering, or you can upgrade to expedited shipping for an additional fee. You'll send it back with a prepaid overnight shipping label, and you can expect results online within 24-48 hours of when the lab receives the sample.

LetsGetChecked COVID-19 Sure-Track Test

Diagnostics and telemedicine company LetsGetChecked has also received EUA from the FDA for its at-home COVID-19 test. Similar to other options on the market, you have to complete a questionnaire, and your responses will be reviewed for eligibility by a physician who works for the company. The company has physicians available 24/7, so if approved, your kit should ship out the next day and arrive via UPS express shipping (typically one to two business days) soon after. You'll return the sample with a prepaid overnight shipping label, and you'll be able to view your results on an app within 24 hours of the lab receiving your sample. LetsGetChecked has the capacity to send out and process 350,000 tests per week but is hoping to increase that to millions per week, according to the company. (For comparison, as of March, Everlywell announced a goal of trying to reach 250,000 test kits per week. As of May, LabCorp had 200,000 kits available with hopes of expanding its capacity.) There isn't an option to bill your insurance directly, but if you're covered, you can pay the $119 cost upfront and then file for reimbursement.

Lucira COVID-19 At-Home Test

The Lucira COVID-19 at-home test became the first self-testing at-home test to receive EUA from the FDA (i.e. this is the first to qualify that doesn't require you to send your sample back to a lab). It's currently authorized for prescription use only. You collect a sample with a nasal swab, swirl it in a vial, then place the vial in a small device included in the test kit. Within 30 minutes, the device will indicate "positive" or "negative." While this test isn't widely accessible just yet, the company is expecting it to be available nationally through health care providers by spring 2021. During clinical tests, the at-home test was compared to "one of the most reliable FDA-authorized" COVID-19 tests, according to Lucira. They matched up with positive results 94 percent of the time, and they matched up on negative results 98 percent of the time.

Ellume COVID-19 Home Test

On December 15, the FDA issued a EUA for the Ellume COVID-19 Home Test, the first of its kind to be available over-the-counter without a prescription. The test kit comes with a sterile nasal swab, a dropper, processing fluid, and a Bluetooth-connected "Analyzer", which pairs with an app on your smartphone. The app will also show you step-by-step video instructions for how to take the test and get your results. After your sample is analyzed, test results are delivered to your smartphone via Bluetooth in 20 minutes or less. In terms of accuracy, the Ellume COVID-19 Home Test correctly identifies 96 percent of positive samples and 100 percent of negative samples in people with COVID-19 symptoms, according to the FDA. In people without symptoms, the FDA says the test correctly identifies 91 percent of positive samples and 96 percent of negative samples. That said, since the Ellume test is an antigen test (which is more likely to produce false-negative results compared to PCR tests), the FDA recommends confirming the results with another test (ideally a PCR test, which tends to be more accurate) "as soon as possible." Availability of the Ellume test — which is expected to cost about $30 or less, the New York Times reports — is limited for now. But the company says it's currently ramping up production efforts and plans to deliver about 20 million home COVID-19 tests to the U.S. in the first half of 2021. So, pretty soon, you'll be able to pick one up at a drug store or pharmacy or purchase it online — no prescription needed.

BinaxNOW COVID-19 Antigen Test

In March, the FDA authorized BinaxNOW, a COVID-19 antigen test that can you can buy OTC without a prescription and perform at home, regardless of whether you're symptomatic. Created by COVID testing manufacturer, Abbott, the test involves a minimally invasive nasal swab (i.e. not as deep as the nasal swabs involved in PCR tests), plus instructions on how to self-administer the test and get your results, which are ready for you at home within 15 minutes, according to the company. Results are consistent with that of PCR tests about 85 percent of the time when positive and nearly 99 percent of the time when negative, according to a press release from Abbott. Perhaps the best part: The tests are expected to be sold in packs of two and will cost less than $10 per test, an Abbott spokesperson told ABC News. The manufacturer will start shipping tests to major retailers "in the coming weeks," according to another press release.

Quidel QuickVue COVID-19 Test

In March, the FDA authorized another home COVID antigen test that you'll soon be able to find at the drugstore without a prescription or symptoms: the QuickVue COVID-19 test by Quidel, a diagnostic healthcare product manufacturer. Similar to the BinaxNOW antigen test, QuickVue's test includes a kit with everything you need, including a nasal swab and instructions for self-testing, and results are ready within 10 minutes, according to Quidel. In a press release, Quidel said its antigen test gives results that are consistent with PCR test results about 84 percent of the time when positive and roughly 99 percent of the time when negative.

DxTerity Diagnostics COVID-19 Saliva At-Home Collection Kit

In January, DxTerity, a genomics company based in Los Angeles, announced that its at-home saliva COVID test was the first of its kind to receive EUA from the FDA for both symptomatic and asymptomatic coronavirus testing. While many COVID tests require a nasal or throat swab, DxTerity's PCR test requires you to spit into an empty tube provided in the test kit, then send the sample to the company's licensed and accredited lab with prepaid overnight shipping (results are typically available between 24 and 48 hours after the sample arrives at the lab, according to DxTerity's website). FYI: You'll need a prescription in order to register for and purchase the test kit, which is available for $110 (or $1,000 for a 10-pack) on Amazon.

Quest Diagnostics RC COVID-19 Flu RT-PCR Test

In December, the FDA granted EUA to the Quest Diagnostics RC COVID-19 Flu RT-PCR test. Available by prescription only, it can indicate whether you tested positive for influenza A, influenza B, and/or COVID-19. This combo deal might prove helpful since flu and COVID-19 symptoms can look similar. It's not yet readily available, but Quest Diagnostics reports plans to make it available to health care providers and employers who want to provide patients or employees with at-home combined COVID-19 and flu testing. (Related: Can Face Masks for COVID-19 Also Protect You from the Flu?)

What about at-home COVID antibody tests?

COVID-19 antibody tests are administered with a finger prick or by drawing blood, and they can detect antibodies produced by the immune system of those who've been infected with the virus. They are most useful after someone has recovered from the infection, and the results are provided on the same day as testing at many clinic locations. Unfortunately, there are currently no at-home COVID antibody test is authorized for at-home use.

"Because it can take several days after the onset of symptoms for antibodies to be made, these tests are not useful for diagnosing COVID-19 in the initial symptomatic period," explains Dr. McAdam.

While these tests are generally accurate, Dr. McAdam says he would "discourage people from seeking them out of curiosity or anxiety." If you're pretty positive that you had COVD-19 and you're interested in your blood donation options, then this in-office test is for you, says Dr. McAdam. (Related: What Does a Positive Coronavirus Antibody Test Result Really Mean?)

While there are sure to be more at-home tests on the market soon, you've already got several options to choose from if you're hoping to test from home sooner.

The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.


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