When the CDC issued new guidance regarding its COVID testing requirement for international travel, effective December 6, 2021, many U.S. travelers who were already abroad had to scramble to do a COVID test within a calendar day of coming home. The new rules shorten the testing period from three days to one and apply to all travelers—vaccinated or not—ages two and up.
Per the CDC: “At this time all air passengers, 2 years or older, traveling to the U.S., regardless of vaccination or antibody status, are required to provide a negative COVID-19 viral test result or documentation of recovery unless exempted.”
That means all travelers entering the U.S. must provide proof of a negative COVID test (PCR, antigen, or approved home tests or self-tests) taken within one day before travel.
Some countries, like Iceland and Denmark, make it very easy and affordable (in some cases, free!) to get a same-day test result, but that’s not the standard around the globe.
Until it is, bringing a set of COVID-19 home or self-tests offers the promise of less hassle. And as of January 15, 2022, the Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of at-home COVID-19 tests, which means they will be eligible for reimbursement through your private health coverage if you have it.
There are some potential hiccups that travelers should be aware of before they buy and pack these tests (see below for our full reviews).
To meet the CDC requirements, the tests can be self-administered as long as they meet these criteria:
- The test must be a SARS-CoV-2 viral test (nucleic acid amplification test [NAAT] or antigen test) with Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA).
- The testing must include a telehealth video call during which someone authorized by the manufacturer supervises the testing procedure in real time. (Note that some FDA-authorized self-tests that include a telehealth service may require a prescription, according to the CDC.)
- The telehealth provider must issue a report confirming the patient’s identity, the name of the laboratory or healthcare entity, the type of test, and the specimen collection date.
- Airlines and U.S. officials at ports of entry must be able to review and confirm your identity and paper or digital documents with your test results.
For those who would prefer to get tested in the destination, numerous airlines as well as international hotels, including in Mexico, Costa Rica, and the Caribbean, have introduced testing options and resources to help Americans fulfill the CDC testing requirement abroad.
Rather pack a self-test? The CDC cautions that some countries may have rules or restrictions in place regarding the importation of COVID-19 test kits that are not authorized or registered there. “Travelers who are considering bringing a U.S.-authorized test with them for use outside of the United States should contact authorities at their destination for information before they travel,” the CDC advises.
At-home COVID tests approved for international travel
So, what are the options for test kits for those who would like to try bringing one along? We tested the following COVID-19 test kits that meet the CDC requirements and offer the self-test option, produce results without a laboratory, and include a telehealth service.
BinaxNOW COVID-19 Antigen Home Test
Buy now: $150 for a pack of six, eMed.com
The BinaxNOW COVID-19 home test is one of the few tests on the market with FDA emergency use authorization that does not require the user to ship a sample to a lab. It’s a rapid antigen self-test designed to detect both asymptomatic and symptomatic COVID-19. It can be used for children as young as 4 when the sample is collected by an adult—those 15 and older can collect their own sample.
BinaxNOW was developed by Abbott, a health and medical diagnostics company. A trained telehealth professional guides users through the at-home self-test during a video call via eMed.com, which will also deliver their COVID-19 test results to their email. The standard kit comes with one nasal swab—the technique for sample collection is less invasive than the very deep nasal swab sample collection we’ve all heard horror stories about (if not endured ourselves).
“It was super easy,” says Bryan Kinkade, AFAR’s publisher, who used the BinaxNOW home tests for himself and his family for a trip to Costa Rica in spring 2021. His one piece of advice is to make sure to have “a solid Wi-Fi connection” so that you can download the app and conduct the telehealth video call. “They walk you through the entire process,” he says, remarking that the test is very similar to a pregnancy test—after 15 minutes or so the results pop up on the reader. “The healthcare provider comes back on camera to verify the results that you hold up to the camera, and then you can instantly see [your] results in the app.”
After getting his results, he uploaded them directly into the United Airlines app to check in for the flight back to the United States. “I repeated the process with my wife and son, and 45 minutes after we started, my son was walking back to the beach for an afternoon surf. We were down there with some friends who were stressed out all week hoping that the local clinic would be open, that there wouldn’t be a line or any issues getting results back quickly.”
Ellume COVID-19 Home Test with Azova
Voluntary Recall Notice: On October 1, 2021, Ellume issued a voluntary recall of specific lots of its Ellume COVID-19 Home Test, due to an “increased chance” that tests may provide an incorrect positive result (also known as a false positive). In a safety communication on October 5, 2021, the U.S. Food and Drug Administration (FDA) confirmed this issue was “due to a recently identified manufacturing issue” and that “negative results do not appear to be affected by the manufacturing issue.” To see if your Ellume COVID-19 Home Test is included in the product recall, compare the lot number on the test carton to the lot numbers on Ellume’s website. If you have unused tests from an affected lot, you can request a product replacement via ellumecovidtest.com/return.
Buy now: Due to supply constraints, Ellume COVID-19 Home tests are currently only available at your local pharmacy. Book a video observation via azova.com
Though BinaxNOW has received a bit more attention, Australia-based digital diagnostics company Ellume was actually the first to market with a COVID-19 home test, and it partnered with Alaska Airlines and Delta Air Lines to give passengers easy access to home antigen tests. (One 15-minute test with a video observation by Azova, an online healthcare provider, will give results for both asymptomatic and symptomatic cases, for ages two and up.) How were they so speedy? Dr. Sean Parsons, Ellume’s CEO and founder, had been working on getting a home flu test to market since 2010 and was able to pivot—the buzzword of 2020—quickly to get approval on a COVID test. “The FDA knew all about our technology, from the work we’d been doing [on the flu test],” Parsons told AFAR. “We feel as if we’re on the cusp—we’re just about there. As a company, we’re already looking to combine our flu assets with our COVID assets to make a combined COVID-flu test, which is the natural progression. It’s coming!”
Until then, international travelers can pack one test kit for every family member over the age of two and—as long as the Wi-Fi is decent and a video-call appointment is scheduled a week out—they can take the Ellume test anywhere in the world. The kit has an easy-to-use smartphone app that asks you to register the bio basics of the patient (name, age, address), then it serves up a mandatory how-to video you can’t fast-forward through (a bit annoying on the fourth go, but understandably necessary). After the step-by-step walkthrough, you swab each nostril, dip the swab in fluid, and put the fluid reader near your phone for 15 minutes. Buzzer goes off, and you have your results, which are also emailed to you.
A friendly reminder that for all antigen tests, false positives are possible. (My two-year-old got one and prompted a fair bit of panic and a follow-up PCR test at a nearby clinic.) “A false positive is really frustrating and worrying and anxiety provoking; a false negative is genuinely dangerous. That’s the tradeoff,” says Parsons. “So we said we’ll chase the positives pretty hard. As a result, we had the best clinical performance of all the rapid tests out on the market. We think that’s still very important for when you go traveling. If you take our test and it’s negative, you can be pretty darn sure that you’re negative.” —Laura Dannen Redman
Cue COVID-19 Test for Home or OTC Use
Buy now: $90 per month for a Cue+ Complete membership
On March 5, 2021, Cue Health received Emergency Use Authorization (EUA) from the FDA to sell its lab-quality molecular COVID test over the counter. It’s a nucleic acid amplification test that returns rapid results—the whole process takes less than 20 minutes—but PCR-level accuracy. Think of this as a home COVID-test investment for frequent travel, in-person meetings, or business travel; companies like Google and the NBA have sent Cue packages home to employees, and U.S. schools have been using them to test grades K–12.
At a minimum, you would have to buy the Cue Reader—a small box about the size of a stack of Post-It notes—and a pack of 3 or 10 individual-use nasal swab tests. You plug in the reader to charge, and while you do that, download the Cue Health app (available on iOS and Android). When the app is fully installed, you follow it step by step: Insert a cartridge to “warm up” in the reader, do a self-nasal swab, and then insert the swab into the cartridge. About 20 minutes later, the results come up on your phone—you can also print them off.
Results are incredibly reliable—according to Cue, an independent study by Mayo Clinic, Cue’s COVID-19 test matched central lab results with 97.8 percent accuracy—but they’ll cost ya: The Cue Reader on its own is $249; a pack of three swab tests is $225. To access the CDC-compliant supervised testing for international travel, you have to sign up for a Cue+ Complete membership ($90 per month), which also includes 20 tests per year; a discounted Cue Reader ($149); 20 percent off additional COVID-19 tests, plus free same-day delivery in select markets; 24/7 access to board-certified doctors; e-prescriptions and prescription renewals; and physician-ordered lab tests.
Though the price is high, these have been the best tests I’ve used in the past six months, including on my children (ages two and four). I have yet to use them abroad but plan to and will report back on the ease of the telehealth appointment. —L.D.R.
Detect Covid-19 Test
Buy now: $75 for starter kit (1 test and 1 hub), $49 for each additional test, and $20 for a video observation session voucher to certify results for travel, detect.com
On December 15, 2021, Detect, Inc. launched its at-home molecular COVID tests authorized by FDA EUA for over-the-counter home use by people ages two and up. While Detect takes longer (about an hour) than many other at-home tests I’ve used, it delivers results with PCR-level accuracy while still being faster than waiting 24 hours to days for results from a lab.
Like Cue, this testing system also requires the purchase of a small device—the Detect Hub—to process the results from a single-use nasal swab. To start, you must download the Detect App (available on iOS and Android) and follow the simple step-by-step video instructions. After you plug in the computer-mouse-size Hub, you can swab your nose then swirl the swab in a liquid-filled test tube. You then place the test tube in the Hub to process for 55 minutes. Once that time has elapsed, you add a separate dropper of liquid into the test reader and push the test tube into the reader, which will give you results within 10 minutes. If you see a single line near the “2” on the reader, your results are negative for COVID-19. If you see two lines or a single line near the “1” on the reader, your results are positive.
In terms of accuracy, Detect tests are comparable to results from PCR tests. According to FDA-reviewed clinical studies, Detect’s Covid-19 tests came back with 97.3 percent accuracy. (Just slightly under Cue’s 97.9 percent accuracy.)
When you compare price points, Detect is a more affordable alternative to Cue. The Detect Hub on its own is $39, and individual tests are $49 each (limited to three tests per order). For $75, you can also purchase a Detect Covid-19 Starter Kit, which includes one hub and one test (a savings of $13 compared to purchasing separately). If items are sold out, check back often. A limited quantity of the Detect Covid-19 tests will be made available at 12 p.m. EST on weekdays via detect.com.
In order to make your results CDC-compliant for international travel, you must also purchase a $20 voucher for a video observation session that comes with a CDC-certified report. While the video session voucher codes are sent to your email after purchase, the hub and tests are sent for free via standard shipping (expedited shipping is also available at cost). Since I haven’t traveled abroad with these yet, I haven’t had the opportunity to try out the video observation session but will report back once I do. —Lyndsey Matthews
Correction (May 11, 2021): The original version of this article mentioned that the BinaxNOW COVID-19 Antigen Self Test, available for $24 at Walgreens, satisfies the CDC’s requirement for international arrivals. That test does not meet the CDC’s requirements and is intended for personal use. The BinaxNOW COVID-19 Antigen Home Test, available on eMed.com and mentioned above, does meet the CDC’s requirements for international arrivals.
This article was originally published on May 10, 2021; it was updated throughout 2021, and again on January 14, 2022, with new information.
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