On January 15, 2022, the Biden/Harris Administration released a mandate where 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 eligible for reimbursement.
Insurance companies and health plans are now required to cover eight free at-home tests per covered member per month.
What Is an At-Home Covid-19 Test?
At-home Covid-19 test kits are diagnostic tests that 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 or are showing symptoms of Covid-19, it is best to quarantine at home and wait 3-5 days before taking the test to ensure the virus will be detected.
How to Get Reimbursed for Your At-Home Covid Test Kits in Michigan
Ambetter from Meridian
As of January 15, 2022, Ambetter Meridian members can receive Covid-19 at-home testing kits at no cost.
The best way to get a testing kit for free is to purchase one from a pharmacy in Ambetter’s network. To see a list of in-network pharmacies, click here.
If you choose to purchase an at-home Covid 19 testing kit outside of the network, you can still get it reimbursed by filling out the member reimbursement form.
To learn more about Ambetter’s policies regarding this new mandate, click here.
Blue Cross, Blue Shield, Blue Care of Michigan
All BCBSM and BCN members can receive reimbursement from Blue Cross Blue Shield of Michigan 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 that 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.
Health Alliance Plan
According to HAP’s FAQ page, they are complying with the federal mandate and will cover up to eight at-home Covid-19 diagnostic tests that are approved by the FDA. For a full list of FDA-approved tests, click here.
The following are eligible:
- Commercial HAP members
- Members of HAP’s large and small employer group plans
- Self-funded plan members
- Individual members who purchase their health plans.
When you purchase a test kit from an in-network pharmacy, you will have no upfront cost. To access a list of HAP-approved pharmacies, click here.
To request an at-home test kit through mail order from Pharmacy Advantage, click here.
If you decide to purchase a test outside the network, HAP will reimburse its members up to $12 per test. To receive reimbursement from a test bought on or after January 15, 2022, fill out the reimbursement form and submit it along with your receipt and UPS or SKU code to the address provided.
McLaren Health
Currently, McLaren’s Covid-19 resource page does not mention at-home testing kits. However, there is a link to their reimbursement form.
The form states that McLaren will reimburse their members if the test is FDA approved and purchased on or after January 15, 2022. Tests purchased before January 15, 2022, are not eligible for reimbursement unless your health care provider ordered them.
A receipt with the date and amount of purchase and a UPC from the package is required to process the reimbursement claim.
Tests for employment purposes are not eligible for reimbursement.
Once the form is completed, you can mail, fax, or email it to the addresses provided on the form.
Oscar
Oscar Insurance 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 and then Submit a Prescription Claim.
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.
PHP Michigan
Physicians Health Plan has announced that PHP members in commercial health plans that include pharmacy benefits are eligible for coverage on-at-home Covid-19 tests. However, this does not apply to PHP members whose pharmacy benefits are not administered through PHP. To learn more, check out their FAQ page.
Up to eight test per member per month can be purchased for those members who qualify.
PHP offers three ways to get at-home Covid-19 tests: (PHPMichigan.com)
- Direct coverage at a participating in-network pharmacy+.
- Reimbursement through CVS Caremark.
- Reimbursement through PHP.
For more information, click here.
If you purchase a test out of network, you can expect to be reimbursed up to $12 per test.
Priority Health
On Priority Health’s FAQ page, they state that members with MyPriority or employer-sponsored plans with pharmacy benefits through Priority Health may be eligible for reimbursement.
To be eligible for reimbursement, you need to purchase an FDA-approved test, fill out and submit a reimbursement form along with the original receipt and the UPC/Barcode on the test kit packaging.
The reimbursement process can take up to 6-8 weeks and will be in the form of a check mailed to the health plan subscriber.
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.
You can also get free at-home tests from community health centers and Medicare-certified health clinics.
