Frequently asked questions and information on reimbursement.
Information about the COVID test program.
The at-home OTC COVID-19 test program allows eligible at-home COVID-19 OTC diagnostic tests to be processed through the pharmacy benefit at no cost or through reimbursement during the public health emergency. The program was designed to help group health plans and private insurance companies meet the federal mandate.
- Submit one form per eligible member.
- Complete the member information.
- Complete as much information as possible. Fields marked with an asterisk (*) are required.
- This program does not apply to Medicare and Medicaid members.
- No printer? Request a form by calling the number on the back of your ID card.
Preferred pharmacies.
At the preferred pharmacy counter for $0.
To obtain at-home over-the-counter Covid-19 tests for no out-of-pocket cost, visit any preferred network pharmacy and bring the tests to the pharmacy counter. Present your member ID card and ask to have tests submitted to your pharmacy plan for for coverage. Since many pharmacies are experiencing supply shortages for these tests, you may want to call the pharmacy in advance.
Preferred pharmacies currently include major chains such as Walmart, RiteAid, Albertsons, Safeway, and Costco, as well as many independent pharmacies.
*This Pharmacy Locator is specific to preferred pharmacies for COVID-19 OTC tests ONLY.
COVID-19 OTC tests may not be available due to shortages. Please contact preferred pharmacies for availability of COVID-19 OTC tests.
Download Preferred Pharmacy List (PDF - 5.4MB)
List is subject to change.
Please note: the PDF document is over 900 pages. Printing is not recommended.
Here's what you need to know.
Which tests are covered?
Where can I obtain a test?
PLEASE NOTE: CVS, Walgreens, Publix, and Kroger will not process at-home over-the-counter COVID-19 tests through your MedImpact pharmacy benefit. If you purchase tests at these stores or through another pharmacy or retailer that is unable to bill directly under your pharmacy benefit, you will need to pay for the tests and submit a reimbursement request.
Starting January 19, 2022, US households can order four
free at-home COVID-19 tests from the federal government
through COVIDTests.gov.
How do I get reimbursed?
If you purchased a COVID OTC test kit on or after January 15, 2022, as long as MedImpact handles Direct Member Reimbursement (DMR) on behalf of your plan, you may submit a DMR form to MedImpact to determine if the claim is eligible for reimbursement.
Need more info?
What is a COVID OTC test kit?
A COVID-19 "over-the-counter" or OTC test can be used completely at home to detect active infections of COVID-19.
Which COVID OTC test kits are covered?
At-home over-the-counter COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration (FDA) are covered.
Are Polymerase Chain Reaction (PCR) test reimbursable?
No. PCR home collection kits that are sent to a lab are not eligible for reimbursement.
Do I need a prescription for a COVID OTC test?
No, like other drugs and products that you can purchase over the counter, COVID OTC test kits do not require a prescription, unless you have a medical condition that allows you to purchase more than 8 test per 30 days.
Where can I obtain an at-home COVID OTC test?
To obtain an at-home over-the-counter COVID-19 test without submitting a DMR form, visit a participating network pharmacy and bring the at-home over-the-counter COVID-19 tests to the pharmacy counter. Present your member ID card and ask to have the at-home over-the-counter COVID-19 tests submitted to your pharmacy plan for coverage. Since some pharmacies are experiencing supply shortages for these tests, you may want to call the pharmacy in advance.
PLEASE NOTE: CVS, Walgreens, Publix, and Kroger will not process at-home over-the-counter COVID-19 tests through your MedImpact pharmacy benefit. If you purchase tests at these stores or through another pharmacy or retailer that is unable to bill directly under your pharmacy benefit, you will need to pay for the tests and submit a reimbursement request.
Starting January 19, 2022, US households can order four free at-home COVID-19 tests from the federal government through COVIDTests.gov.
What is the advantage of purchasing the COVID OTC test at the pharmacy?
At in-network pharmacies, the test will be a $0 copay if purchased at the pharmacy counter when the test is submitted to your plan for coverage.
How can I find out if COVID OTC tests are reimbursed by my health plan?
Ask your employer or health plan.
How will I be reimbursed if I paid out-of-pocket for my COVID OTC tests?
If you purchased a COVID OTC test kit on or after January 15, 2022, as long as MedImpact handles Direct Member Reimbursement (DMR) on behalf of your health plan, you may submit a DMR form to MedImpact to determine if the claim is eligible for reimbursement.
Can I be reimbursed for COVID OTC tests purchased before January 15, 2022?
Plans are not required to reimburse for COVID OTC tests purchased before January 15, 2022.
How many COVID OTC tests can I get?
Each covered person on your commercial insurance plan may receive up to 8 COVID OTC tests per 30 days.
For example, a family of four could receive up to 32 tests per 30 days.
Some test kits may contain more than one test.
Can I get all 8 COVID OTC tests at once?
Yes. Each member, ages 2 years and older, is eligible for up to eight (8) at-home over-the-counter COVID-19 tests with NDCs with Emergency Use Authorization (EUA), per 30 days. A member may purchase or submit for reimbursement a total of eight (8) at-home over-the-counter COVID-19 tests at once, every 30 days. The lookback period is a rolling 30-days.
How much will I pay for a 9th COVID OTC test within 30 days?
Each member, ages 2 years or older, is eligible for up to eight (8) at-home over-the-counter COVID-19 tests with NDCs with Emergency Use Authorization (EUA), per 30 days. If a ninth at-home over-the-counter COVID-19 test is purchased within the 30-day window and submitted for reimbursement, the ninth claim will reject at point of sale or reject as a DMR under the pharmacy benefit.
What if I have Medicare or Medicaid?
Medicare and Medicaid plans have different rules. There are no new policies for home COVID tests at this time and members should follow the existing benefits with their existing Medicare and Medicaid plans until they are contacted by their health plan.
I don’t have a printer. How can I request a copy of the reimbursement form?
Please call the number on the back of your ID card and ask for a member reimbursement form to be mailed to you.
Additional information about test kits.
The US government is also purchasing 500 million at home test kits that will be available by mail for free beginning January 19 at COVIDTests.gov
