The Biden/Harris Administration issued a mandate on January 15, 2022. Individuals with private health insurance coverage or group health plans can now purchase at-home Covid-19 test kits with no upfront costs or be reimbursed.
Insurance companies and health plans must now provide eight free at-home tests per covered member per month.
What Is an At-Home Covid-19 Test?
At-home Covid-19 test kits detect specific proteins on the virus’s surface and are used to detect an active coronavirus infection.
If you have come into contact with someone who has Covid-19 or is experiencing symptoms, it is best to quarantine at home and wait 3-5 days before taking the test to ensure the virus is detected.
How to Get Reimbursed for Your At-Home Covid Test Kits in Illinois
Ambetter of Illinois
Ambetter’s FAQ page states that they provide free at-home testing kits to their members with no upfront cost through pharmacies in their network. Common participating pharmacies are CVS and Rite Aid. For a full list of in-network pharmacies, click here.
If you decide to purchase a kit outside of the approved network of pharmacies, you can still get reimbursed. To start the reimbursement process, fill out the member reimbursement form.
Ambetter will reimburse you up to $12 per test per covered member. In addition, if you purchased a test kit before January 15, 2022, Ambetter will still reimburse you if you include a physician prescription.
Blue Cross Blue Shield of Illinois
All BCBSM members can receive reimbursement from Blue Cross Blue Shield of Illinois for up to eight at-home Covid-19 diagnostic tests per month. You can find these tests over the counter at a pharmacy, retail store, or online store. To learn more, check out their at-home Covid-19 testing and reimbursement page.
To be eligible for reimbursement, you’ll need the following:
- An FDA approved test
- A receipt for the amount paid
- A reimbursement form is printed out and mailed to the address provided.
Once the forms are received, they will be processed, and a check will be mailed back. This process could take up to 60 days.
Please note:
- Reimbursement does not apply to tests used for employment purposes.
- Blue Cross will still cover other types of COVID-19 diagnostic tests if they are FDA-approved or authorized and determined appropriate by a qualified health professional.
- The new program does not include Medicare Advantage plans.
Bright Health
Bright’s FAQ Covid-19 Resource page states toward the bottom that they will cover at-home Covid-19 test reimbursement according to the mandate.
Starting January 15, Bright HealthCare will cover diagnostic at-home tests for members under their individual, family plan, and small group members.
Members can purchase FDA-approved tests either online or through a pharmacy or store. You will need to pay for your test upfront, but you will be reimbursed for the actual cost of the test.
To submit a reimbursement claim, you need to fill out the form and include your proof of purchase and mail it to the address provided on the form. Or you can visit the Member Hub and send a secure message with the reimbursement form and proof of purchase online.
Cigna Healthcare
Their Covid-19 resource page states that they will provide free Covid-19 test kits with no upfront cost when test kits are purchased from a location in their network.
Like all other health insurance companies, according to the new Biden-Harris mandate, Cigna will provide eight at-home test kits per member per month.
If you purchase a test kit and pay upfront for it, keep the receipt and the UPC on the box and submit a claim for reimbursement. You can submit the claim through the mail or by faxing it.
MercyCare Health Plans
MercyCare’s at-home Covid-19 Resource states that starting January 15, MercyCare will reimburse eligible individual non-Medicare members and those on employers’ plans per the mandate.
To receive at-home tests with no upfront costs, they recommend you visit an in-network pharmacy, take the FDA approved test to the pharmacy counter, and have them run the test through your member ID like they would a prescription.
If you decide to purchase an FDA-approved at-home test some other way, you are eligible for reimbursement of up to $12 per test. To apply for reimbursement, submit a Direct Member Reimbursement form along with the original receipt and the NDC number on the package.
Oscar Health Plan
Oscar’s at-home Covid test reimbursement FAQ does not state that you can get free at-home testing kits through their in-network pharmacies upfront. They do, however, state that “you may be able to present your member ID and ask them to bill your insurance just like you would a medication at no cost to you.” (HIOSCAR.com)
To check which pharmacies are in their network, click here.
If you have a test you would like to get reimbursed, visit Caremark.com, sign in, select Plan & Benefits, request reimbursement, or click here for the reimbursement form.
To be eligible for reimbursement, you must be an active member enrolled in individually purchased health care or a small group plan, bought an FDA-approved test, and have the receipt from the purchase.
United Healthcare
According to United Healthcare’s resource page for over-the-counter at home Covid-19 tests, they state that members with an OptumRx logo on their ID card are now able to purchase at-home or OTC tests in two ways:
- For no upfront costs, members must visit an in-store pharmacy counter at a pharmacy that is in-network. To see a list of in-network pharmacies, click here.
- For reimbursement, you can purchase an FDA-approved test in-store or online and submit your receipt online at myuhc.com or fill out a reimbursement form and mail it in.
Covid-19 tests can be reimbursed up to $12 or $24 for kits that contain two tests in one box.
If you do not have an OptumRX logo on your member ID, you are still eligible for reimbursement at both links provided above.
Reimbursement will be provided through the method of your choosing (direct deposit or check by mail) and is typically sent within 10-20 days
Additional Important Information
The government launched a website on January 19, 2022, where you can sign up to receive four free at-home test kits per household and receive them through the USPS.
For a full list of FDA-approved at-home testing kits, click here.
You can also get free at-home tests from community health centers and Medicare-certified health clinics.
Resources:
Hyperlinks used in the article:
- https://www.hhs.gov/about/news/2022/01/10/biden-harris-administration-requires-insurance-companies-group-health-plans-to-cover-cost-at-home-covid-19-tests-increasing-access-free-tests.html
- https://www.ambetterofillinois.com/coronavirus/covid-19-home-testing-kits.html
- https://guide.ambetterhealth.com/
- https://www.ambetterofillinois.com/content/dam/centene/ambetteril/pdfs/AMB-IL-Mbr-RMCF-COVID-Test.pdf
- https://www.bcbsm.com/index/common/important-information/covid-19.html
- https://www.bcbsm.com/content/dam/public/shared/documents/coronavirus/covid-testing-member-reimbursement-form.pdf
- https://brighthealthcare.com/covid-19
- https://cdn1.brighthealthplan.com/docs/covid_19/covid_otc_test_reimbursement_loomis.pdf?_ga=2.48984550.1119154873.1644614590-1416111415.1644614590
- https://www.cigna.com/coronavirus/
- https://www.cigna.com/static/www-cigna-com/docs/coronavirus/covid-otc-med-claim-form.pdf
- https://mercycarehealthplans.com/wp-content/uploads/2014/12/Coverage-of-OTC-COVID-19-Tests.pdf
- https://mercycarehealthplans.com/wp-content/uploads/2014/12/OTC-Covid-19-At-Home-Test-Claim-Form.pdf
- https://www.hioscar.com/blog/at-home-covid-test-reimbursement
- https://www.hioscar.com/at-home-covid-test-reimbursement
- https://www.hioscar.com/member/search/results/facilities?specialty_id=3336C0003X&search_query=Retail%20Pharmacy
- http://caremark.com/
- https://assets.ctfassets.net/plyq12u1bv8a/534MPK4tSOUJBuevzhQYED/5e6cce2ef072186b934a910ba836dfff/OTC_COVID_Test_Paper_Claim_Form.pdf
- https://www.uhc.com/health-and-wellness/health-topics/covid-19/coverage-and-resources/covid-19-at-home-testing-coverage
- https://www.uhc.com/health-and-wellness/health-topics/covid-19/coverage-and-resources/covid-19-at-home-testing-coverage/preferred-retailers
- https://member.uhc.com/coronavirus?q=Covid+test+reimbursement&_gl=1*19owp2*_ga*MTc1NDY5OTg4Mi4xNjQzNDE2NzE1*_ga_HZQWR2GYM4*MTY0MzQxNjcxNS4xLjEuMTY0MzQxNjc1OC4w
- https://www.uhc.com/content/dam/uhcdotcom/en/memberresources/forms/PDF-UA-Over-the-Counter-OTC-At-home-COVID-19-Test-Reimbursement-Form.pdf
- https://www.covidtests.gov/
- https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/in-vitro-diagnostics-euas
- https://www.hrsa.gov/coronavirus/testing-supplies
