UnitedHealthcare has agreements with Walmart and a growing list of retailers to make available free at-home COVID-19 tests when subscribers present their ID cards at pharmacy counters.

The benefit is available to more than 26 million people with UnitedHealthcare commercial insurance, a group that primarily consists of those covered by employer-sponsored health plans.

Minnetonka-based UnitedHealthcare, which is the nation's largest health insurer, has seen in recent weeks a 10% decline in primary care visits and a larger drop in patients visiting specialist physicians with the surge of infections caused by the omicron variant.

Company officials say reduced expenses stemming from those missed visits might well offset the cost of providing the new testing benefit, which was mandated by the Biden administration last week.

"At this point, [it's] a little hard to know exactly ... what the kind of scale of the testing program could be," Andrew Witty, the chief executive at parent company UnitedHealth Group, told investors Wednesday.

"But you would logically expect that if there was a high, sustained demand, there's probably a lot of omicron or some kind of variant in the system, that would probably lead to … abatement elsewhere in the system," Witty said. "At this level, I think we kind of expect these two things to somewhat offset. Obviously, we don't know."

The comments came as parent company UnitedHealth Group released fourth-quarter results that beat expectations for earnings and revenue during the fourth quarter. The company's profit for the three-month period ending Dec. 31 surged by 84% compared with the previous year, growing to just over $4 billion.

Under the Biden requirement, private health insurers must cover at-home COVID-19 testing costs of up to $12 per individual test, or $24 for a package that contains two tests. Health plans must pay for up to eight tests per person per month. Consumers have been encouraged to check with insurers for details on how to access the benefit.

While health plan subscribers in many cases can pay nothing out of pocket when obtaining tests at certain retail pharmacy counters, the federal government says insurers also must reimburse consumers for tests purchased elsewhere.

The at-home testing coverage is not available to those covered through the original Medicare program, although the federal government is pointing those seniors to other testing options. People enrolled in Medicare Advantage health plans are advised to check with their insurer to see if they have coverage for at-home tests.

With omicron's surge, many consumers have been frustrated by shortages in at-home tests. Witty said he believed Walmart and other pharmacy partners have expertise with supply chains that should help minimize problems, although some shortages likely will continue.

"I think it's inevitable that we're going to continue to see outages as you go through these geographic kind of surges that have characterized this pandemic," Witty said.

In recent weeks, the level of inpatient hospital care needed for COVID-19 among UnitedHealthcare subscribers has been similar to January 2021, even though infection rates this month are about four times higher, John Rex, the company's chief financial officer, said Wednesday.

"For those people needing inpatient care, severity is seemingly lower as we are seeing shorter lengths of stay compared to that earlier period," he said.

During the fourth quarter, the health insurance business was the bigger source of revenue at UnitedHealth Group, while the company's health services business Optum generated more operating income. Operating margin during the quarter also was higher at Optum, which runs medical clinics, sells data consulting services and operates a large pharmaceutical benefits management (PBM) business.

UnitedHealth Group posted a profit of $4.07 billion on $73.74 billion in revenue, compared with a profit of $2.21 billion during the fourth quarter the previous year. After adjusting for one-time items, adjusted earnings per share of $4.48 beat the $4.31 expected among analysts surveyed by Refinitiv.

The company maintained financial guidance for the new year including adjusted earnings per share of $21.10 to $21.60 on full-year revenue of $317 billion to $320 billion.

UnitedHealth Group is Minnesota's largest company in terms of revenue. The company employs about 340,000 people around the world, including about 18,000 in Minnesota.