A COVID-19 "over-the-counter" or OTC test can be used completely at home to detect active infections of COVID-19.

At-home over-the-counter COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration (FDA) are covered.

No.  PCR home collection kits that are sent to a lab are not eligible for reimbursement.

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.

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.

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.

Ask your employer or health plan.

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.

Plans are not required to reimburse for COVID OTC tests purchased before January 15, 2022.

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.

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.

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.

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.

Please call the number on the back of your ID card and ask for a member reimbursement form to be mailed to you.