Introduction
The Department of Health and Welfare (DHW) in Idaho state is supplying free at-home COVID-19 tests. Tests can be requested by simply dialing 2-1-1. No personal information is required apart from the mailing address and the name. Individuals who experience any COVID-19 symptoms are encouraged to get tested. Widely available and reliable testing is an integral part of the state’s effort to stop the spread of the coronavirus. Therefore, DHW is working hand in hand with VAULT Medical to provide PCR testing on saliva for Idaho residents. Saliva collection can be done in the convenience of an individual’s home and with the assistance of a trained VAULT medical professional via a zoom visit. Residents are thus required to create an account using their emails in order to use VAULT tests. After that, they can contact a remote observer and collect the saliva specimen as the observer watches. The samples will be mailed to VAULT via UPS, and results should be expected within 24-72 hours. The tests will be reported to the Idaho state government (DHW Communications, 2021).
Many state officials, including from Idaho state, welcomed the Biden administration strategy. The strategy required private insurance companies to reimburse members for the cost of at-home rapid tests (Olson, 2021). This report, therefore, will discuss how these private insurers in Idaho state provide reimbursement for their enrollees.
How To Get Reimbursement
Regence Blue Shield of Idaho, Inc.
For the first eight over-the-counter at-home COVID-19 tests, members will not need a prescription to obtain the tests. The at-home tests covered by the plan must be Food and Drug Administration (FDA) approved or authorized, and it should be for personal use. Tests, however, required for employment, tracking activities like sports, traveling, or concerts are not covered. The number of tests covered by the plan is eight per member per month. In situations where a member requires additional tests, they must provide a prescription from a medical provider. Members can sign in to their Regence account to find in-network pharmacies to purchase at-home tests with no upfront cost. Plan members can also buy these tests from an out-of-network pharmacy or retailer and request a reimbursement (Regence Blue Shield of Idaho, Inc., 2022).
You can download reimbursement form, then follow the instructions on the form, include your itemized documentation like a receipt with the date of purchase, and mail it Regence Blue Shield of Idaho. A separate form for each member must be submitted. The reimbursement amount is a maximum of $12 per test; taxes and shipping costs are not included in the reimbursement. The reimbursement policy has been effective since January 15, 2022, and tests purchased before that are not eligible for reimbursement unless prescribed by a health provider (Regence Blue Shield of Idaho, Inc., 2022).
Members will receive their reimbursement within six weeks from the date the insurer received their request. Also, the at-home tests are eligible to be reimbursed or paid for under the health flexible spending arrangement (FSA) or health saving account (HAS). Still, members are not eligible for reimbursement from their HSA or FSA if they are reimbursed by insurance. Also, when a provider orders COVID-19 tests, including at-home tests as part of medical care, the cost will be covered (Regence Blue Shield of Idaho, Inc., 2022).
PacificSource Health Plan
Through the company’s pharmacy benefit, CVS Caremark, members under commercial category can obtain at-home free of charge COVID-19 rapid tests at participating pharmacies. Eligible members will receive eight at-home rapid tests per month without a prescription. Only specific FDA-approved tests are eligible when purchased through the pharmacy benefit. Also, any FDA authorized at-home tests are covered for members who choose to self-pay. Members who purchase these tests from participating pharmacies, and go through the front checkout register, will be considered out of network and subject to a $12 maximum allowable reimbursement (PacificSource, 2022).
Enrollees who choose to pay out of pocket and seek reimbursement will need to submit a request via CVS Caremark online portal. Members should also ensure they have uploaded a copy of the receipt before submission. CVS Caremark also supports a mobile app available through the app store. Verification will also be required to attest that the test is for personal use and not for resale. In addition, enrollees can submit paper claims to CVS Caremark and attach a copy of the receipt as proof of purchase (PacificSource, 2022).
Mountain Health Co-op
The company is now reimbursing members for OTC at home COVID-19 tests purchased on or after January 15. However, the coverage is not provided to non-treatment, or non-diagnostic use like travel required testing (Mountain Health Co-op, 2022).
To claim reimbursement, members must complete all information on the claim form and include itemized pharmacy receipt for test then submit it via email or as per the information provided. By submitting the claim, a member acknowledges that the test is for personal use and not for resale. Proof of online purchase is also, required. The company, however, does not reimburse postage costs (Mountain Health Co-op, 2022).
Conclusion
VAULT Medical professionals now offer assistance via zoom to residents in Idaho to self-test and send a saliva sample to VAULT for assessment. With the new guideline, private insurers like Mountain health, Regence Blue Shield of Idaho, and PacificSource Health Plan now reimburse members for OTC at-home tests purchased on or after January 15. The tests must be FDA-approved to be eligible. Members can purchase these kits at participating pharmacies or out of network and seek reimbursement. These plans, however, reimburse a maximum of $12 per individual test. Medicaid members under PacificSource can also obtain four at-home tests and get reimbursed. Medicare members, however, are not covered. But members on the original Medicare or Medicare advantage plan this spring will obtain at-home tests through participating pharmacies.
References
DHW Communications. (2021). Free, at-home COVID-19 tests are available in Idaho by dialing 2-1-1 | Idaho Department of Health and Welfare. Healthandwelfare.idaho.gov. Retrieved February 8, 2022, from https://healthandwelfare.idaho.gov/news/free-home-covid-19-tests-are-available-idaho-dialing-2-1-1.
Mountain Health Co-op. (2022). Mountain Health CO-OP is now reimbursing covered members for Over-The-Counter Covid-19 testing. Retrieved February 8, 2022, from
Olson, L. (2022). At-home COVID tests to be covered by insurance — but details still to come – Idaho Capital Sun. Idaho Capital Sun. Retrieved February 8, 2022, from https://idahocapitalsun.com/2021/12/02/at-home-covid-tests-to-be-covered-by-insurance-but-details-still-to-come/.
PacificSource. (2021). At-Home COVID-19 Test Kits FAQ. PacificSource Blog. Retrieved February 8, 2022, from https://blog.pacificsource.com/home/covid-19-updates/covid-19-at-home-test-kits/.
Regence Blue Shield of Idaho, Inc. (2022). COVID-19 information and resources. Regence.com. Retrieved February 8, 2022, from https://www.regence.com/member/health-lifestyle/coronavirus-covid-19#What-if-I-have-a-prescription-for-a-COVID-19-test-that-I-take-at-home-but-send-to-a-lab-or-that-requires-a-prescription-.
