Are At-Home COVID-19 Tests Accurate?
At-home COVID-19 tests, called rapid antigen tests, are a quick, convenient way to test yourself for COVID-19. However, these tests are not perfect. At-home COVID-19 tests detect about 85% of positive cases on average.
At-home testing can help you determine if your symptoms are COVID-19, the flu, or just a cold. If you are feeling sick, and want to seek additional care, a membership with Mira can help you access affordable urgent care services for as low as $25 per month!
Accuracy of At-Home COVID-19 Tests
Each at-home COVID-19 test is slightly different, but most of them are estimated to correctly identify between 73.0% and 98.9% of COVID-19 cases. This percentage refers to the sensitivity of the test, which is the chance that the test will detect someone who is positive with COVID-19. At-home COVID-19 tests are more sensitive in people with symptoms within the first few days of symptom onset, as this is when the viral load is highest.
In comparison to laboratory-based molecular tests, at-home COVID-19 tests have a higher chance of false-negative results, meaning the test reads negative when you have COVID-19. If your first test is negative, it is recommended to test again in 24-48 hours to rule out the possibility of a false negative when you have been exposed or are experiencing symptoms.
If the second test is still negative, you may not be infected, but if you are at high risk, have been exposed, or are still experiencing symptoms, you should talk to your healthcare provider about getting a laboratory test.
In summary, a positive result is highly accurate, meaning if you test positive, you most likely have COVID-19. However, one negative test result does not necessarily rule out COVID-19 infection.
Below we outline the sensitivity of many at-home COVID-19 tests. The tests with higher sensitivities are preferable, as they are more likely to detect infection with COVID-19. The tests with the highest sensitivities are Lucira Check It COVID-19 Test, Ellume COVID-19 Home Test, and iHealth COVID-19 Antigen Rapid Test.
Comparison of At-Home COVID-19 Test Accuracy
|Name of Test||Sensitivity|
|Abbott BinaxNow COVID-19 Antigen Self Test||84.6%|
|Access Bio CareStart COVID-19 Antigen Home Test||87%|
|Acon Flowflex COVID-19 Antigen Home Test||93%|
|BD Veritor At-Home COVID-19 Test (app required)||84.6%|
|Ellume COVID-19 Home Test (app required)||95%|
|iHealth COVID-19 Antigen Rapid Test||94.3%|
|Intrivo On/Go COVID-19 Antigen Self-Test (made by Access Bio)||87%|
|OraSure InteliSwab COVID-19 Rapid Test||84%|
|Quidel QuickVue At-Home OTC COVID-19 Test||84.8%|
|Detect (app required, PCR test)||90.9%|
|Lucira Check It COVID-19 Test (app required, PCR test)||94.1%|
Source: NY Times
FDA Approved At-Home COVID-19 Tests
There are 13 FDA-approved at-home COVID-19 diagnostic tests. Most of them are available over-the-counter at your local drug store, but you need a prescription to purchase a select few. At-home COVID-19 tests are meant for people with symptoms of COVID-19 to use within the first seven days of symptom onset.
Some approved at-home COVID-19 tests require you to get a prescription from a doctor in order to purchase. The out-of-pocket cost of an at-home COVID test can cost as much as $25 for two tests, but the price depends on the brand. Below we outline whether you are able to get each FDA-approved at-home COVID-19 test over the counter (OTC).
The following at-home tests are available OTC:
- BinaxNOW COVID-19 Antigen Self Test
- BinaxNOW COVID-19 Ag Card 2 Home Test
- CareStart COVID-19 Antigen Home Test
- Flowflex COVID-19 Antigen Home Test
- BD Veritor At-Home COVID-19 Test
- Celltrion DiaTrust COVID-19 Ag Home Test
- Ellume COVID-19 Home Test
- iHealth COVID-19 Antigen Rapid Test
- InteliSwab COVID-19 Rapid Test Rx
These tests are not available OTC and require a prescription:
- BinaxNOW COVID-19 Ag Card Home Test
- InteliSwab COVID-19 Rapid Test Rx
- QuickVue At-Home COVID-19 Test
Importance of Taking an At-Home COVID-19 Test Correctly
There are several factors that can affect the accuracy of at-home COVID-19 tests. Inaccurate results can be prevented by carefully reading the instructions included in the packaging. Some universal precautions include:
- Check the expiration date. Don’t use expired tests or test components that are damaged or appear discolored based on the manufacturer’s instructions.
- Be sure to swab correctly. Failure to collect an adequate sample can result in an incorrect or invalid result. Both nostrils must be swabbed firmly around the inside wall.
- Use a timer to determine the right length of time to leave the swab in the solution. After swabbing, immediately place the swab into the liquid in the tube. It should be touching the bottom of the tube, and then stir. If the swab is in too long, or not long enough, the test should not be used, so check the instructions carefully.
- Don’t touch the wrong part of the test strip. Depending on the test you use, there are different ways you will determine your results. Most require you to dip a test strip into the tube after removing the swab.
- Read the results correctly. Each instruction packet will have explicit directions, and often images, to help you accurately read the results of your at-home COVID-19 test. This step is imperative in assuring you know the true results of the test.
If you do not take the at-home test properly, you may have inaccurate results. If you are confused by the instructions in your testing kit, there may be videos online demonstrating how to take a COVID-19 test correctly.
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How to Use At-Home COVID-19 Tests
It is important to use your at-home test properly in order to get the most accurate results. Each test varies slightly, so be sure to read the instructions in the box before attempting to take a sample. Some tests will only have you swab one nostril, while others will have you swab both. In addition, each test will have different instructions for obtaining results. Follow the instructions below to collect a nasal sample for most tests:
- Keeping fingers away from the swab end, open swab package at stick end. Take a swab out.
- Swab one nostril carefully by inserting the entire soft tip of the swab into a nostril (usually ½ to ¾ of an inch). You do not need to go deeper. Using medium pressure on the walls of your nostril, make at least 5 big circles for about 15 seconds. Do not just spin the swab.
- Using the same swab, repeat in your other nostril.
At-Home COVID-19 Tests Frequently Asked Questions (FAQs)
As the pandemic continues, it is important to monitor your own health and can be useful to learn how to correctly use at-home COVID-19 tests. At-home tests are a convenient way to determine if you have COVID-19 and should quarantine.
When should I do an at-home COVID-19 test?
If you want to get tested frequently for COVID-19 without going to the doctor every time, at-home testing is a convenient, and often cheaper, solution. A PCR test administered by a health care provider is usually more accurate, but the results may take a few days to get back to you, especially if they do not have a processing lab on-site.
At-home testing can save you unnecessary trouble disputing medical bills as well. Over the course of the pandemic, many people have been wrongly charged by urgent care centers for COVID tests.
However, it is important to note that at-home tests are usually not sufficient for travel purposes. Many countries require a negative PCR test within 72 hours of travel, which can be obtained at a doctor’s office, testing site, or urgent care clinic. If you are planning on traveling, make sure to review the travel guidelines and testing requirements for your destination.
Does health insurance cover at-home COVID tests?
Currently, at-home COVID-19 tests are expensive and there is a nationwide shortage. There has been talk of putting a reimbursement structure in place for at-home COVID tests, but health insurance does not cover them at this moment.
President Biden’s new COVID-19 plan outlines a strategy to provide access to free at-home testing for all Americans. The New York Times reports, “Under the president’s plan, at-home tests would be reimbursed for the 150 million Americans with private insurance. To ensure access for those who lack insurance, or who are covered by Medicaid, the administration intends to distribute an additional 15 million tests to community health centers and rural clinics.”
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Do at-home COVID-19 tests hurt?
At-home COVID-19 tests should not hurt. The nasal swab is not sharp, but sometimes the swab can feel slightly uncomfortable while it is in your nose and make you sneeze. If you feel pain, stop the test and seek advice from a healthcare provider.
What is Serial Testing?
COVID-19 Serial Testing refers to routine testing for COVID-19, such as getting tested every day or every other day. By testing more frequently, you may detect COVID-19 more quickly and reduce the spread of infection. Serial testing is more likely to detect COVID-19, especially when you do not have any symptoms.
How soon will I get my results?
Most at-home COVID-19 results will have your results ready within 30 minutes of taking the test, but some can determine your results in under 10 minutes. Since each test varies slightly, be sure to read all of the instructions carefully before beginning the process.
What if I test positive for COVID-19?
If you test positive with an at-home COVID-19 test, you should self-isolate and seek follow-up care with your healthcare provider. To avoid spreading the virus, you should isolate yourself and follow the CDC’s guidelines. Stay in one room as much as possible and away from people and pets. Do not use public transportation until you are sure you are not contagious
As we adjust to a new normal with COVID-19, at-home testing is an easy way to stay informed about your health status. If you have flu-like symptoms or have been exposed to someone with COVID-19, an at-home test is a convenient way to check if you have COVID-19.
For only $25 per month, Mira can help you access low-cost urgent care, discounts on prescriptions, and affordable lab testing for all of your health needs. Start saving on your health today!
Alexis Bryan MPH, is a recent graduate of Columbia’s Mailman School of Public Health. She is passionate about increasing access to care to improve health outcomes. Outside of work, she loves to travel, read, and pay too much attention to her plants.