How to Get My At-Home COVID-19 Test Covered by Insurance?

We have a limited supply of $12 COVID-19 test kits available for sale. 

 

The Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of over-the-counter, at-home COVID-19 tests, so people with a private health plan can get them from free starting January 15, 2022. This means that you can go online, to a pharmacy or store, buy a COVID-19 at-home test and get reimbursed for the cost by submitting a claim with your insurance provider. The COVID-19 diagnostic test must be authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA). Visit the FDA website for a list of authorized tests.

Insurance companies are required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Health plans must cover 8 individual at-home COVID-19 tests per person enrolled in the plan per month. That means a family of four can get 32 tests per month for free.

We have answered your frequently asked question about this new coverage below and put together a list of instructions per insurance on how to file a claim for reimbursement. 

1. Where do I get a free at-home over-the-counter COVID-19 test?

Starting January 15, 2022, the COVID-19 tests will be free directly at the point of sale, if your health plans provides for direct coverage, or by reimbursement if you are charged for your test. You may purchase the at-home test online, at a pharmacy, or at a store. If your plan has set up a network of preferred providers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers outside that network. Make sure to save your receipt if you need to submit a claim to your insurance company for reimbursement.

$12 covid-19 at home test kit

2. Can I buy more than one test at a time?

Health plans must cover 8 individual at-home over the counter COVID-19 tests per person enrolled in the plan per month, regardless of whether the tests are bought all at one or at separate times during the month. Generally, the limit of 8 tests per person per month does not apply if tests are ordered or administered by a healthcare provider following a clinical assessment.

3. Do I need a prescription to file a claim?

No you don't. Just make sure to save your receipt.

4. If I pay upfront, how do I get reimbursed? 

Starting January 15, 2022, if you are charged for your test, keep your receipt and submit a claim to your health plan for reimbursement. See the instructions below based on your insurance provider. 

 Things you will need to file your claim:

  1. Your health plan ID number.
  2. The date of service (this should be on your receipt)
  3. The charge of each type of service and a receipt showing how much you paid out of pocket. You will also need to attach the receipt with your form, so make sure you make additional copies of your receipt. Keep a copy of your form and receipt for your records. 

Aetna:

To submit a claim for reimbursement, go to your Aetna member website and fill out the reimbursement form. You can also print and fill the form to mail your claim to them.

**Note: This new coverage policy isn’t available under Medicare, Medicare Supplement, Medicaid or our supplemental accident, critical illness and hospital indemnity plans.**

Cigna:

For tests purchased on or after January 15, 2022, you can download the COVID-19 Over-the-Counter OTC Test Kit Claim Form and submit via mail or fax using the instructions on the form. 

**Original Medicare and Medicare Advantage plans are not part of this program. Cigna Medicare Advantage plans will cover the costs for COVID-19 tests done in a clinical setting, but do not cover the purchase of at-home COVID-19 tests.**

UnitedHealthcare:

You may submit your purchase receipt for reimbursement for a maximum reimbursement of up to $12 per test using the reimbursement form

**This particular benefit does not apply to Medicare Advantage members. **

Blue Cross Blue Shield:

You may use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket.

**Medicare: Over-the-counter diagnostic tests are not covered at this time. COVID-19 tests ordered by a health care professional continue to be covered at no cost under your medical benefits. **

Optima Health

Any commercial member that pays out-of-pocket for covered OTC COVID-19 tests on or after January 15, 2022, can submit a claim using this form to Optima Health for reimbursement.

**At this time, Medicare and Medicaid members are not covered under this program.**

Anthem

Log in to anthem.com, go to Claims & Payment, and choose Submit a Claim.

**If you have an Anthem Medicaid or Medicare plan, you will need to visit your member website for information on how your health plan covers COVID-19 testing.**

If you have any questions regarding your coverage, please leave your questions in the comments below, and we will try our best to provide answers as soon as we can.

Leave a comment

Insurance Covered Wigs for cancer patients