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 Oregon
BridgeSpan
BridgeSpan’s Covid-19 testing FAQ page states that due to the mandate, they will be covering the cost of eight at-home rapid tests per member (age two and older) per month free of charge. The tests must be needed for diagnostic reasons only. This means you need to have symptoms or close contact with an infected person.
Only FDA-approved tests will be covered under this mandate.
For no up-front cost, you need to visit an in-network pharmacy in person and bring the test to the pharmacy counter so they can bill your insurance directly. To find in-network pharmacies, click here.
If you buy your test from an out-of-network location, you can still be reimbursed. Save your receipt and submit your claim online or by mail. BridgeSpan will reimburse you up to $12 per test. To submit a claim, click here.
If you have a health savings account (HSA) or flexible spending arrangements (FSA), you can receive payment or reimbursement for your at-home tests. However, you are not eligible if the insurance has already reimbursed you.
Kaiser Permanente
Kaiser Permanente’s Covid-19 testing resource page states that they offer reimbursement. To submit a reimbursement, click here.
To be eligible to submit a claim, you need to do the following:
- Purchase an FDA-approved at-home test.
- Keep your receipt and test kit box (for the UPC code)
You can submit your reimbursement claim online or by mail.
As supplies allow, Kaiser Permanente members also have the option to pick up Covid-19 self-tests at medical offices by appointment only. Members can schedule a time and location for pick-up through KP.org or by calling 1-800-813-2000 (Healthy.Kaiserpermanente.org). If able to, members are given two tests per appointment, per week.
Moda Oregon
Moda’s at-home Covid-19 test FAQ page states that members with individual, family, and employer group coverage can benefit from this mandate.
To get a free test with no upfront cost, Moda suggests that you visit an in-network pharmacy in person, take the test to the pharmacy counter and show them your member ID. To find an in-network pharmacy click here.
If you visit a location that is not in-network, Moda will reimburse you after you fill out and send a reimbursement claim. In addition, they will reimburse you up to $12 per test for tests purchased on or after January 15, 2022.
- For tests purchased in-person at a pharmacy that needs to be reimbursed, fill out this form.
- For tests purchased from an online pharmacy that needs to be reimbursed, fill out this form.
- For tests purchased at a normal retail location both in-person and online that needs to be reimbursed, fill out this form.
After your claim has been received and accepted, you will receive a check in the mail.
PacificSource
PacificSource’s at-home Covid-19 test kit FAQ page states that through CVS Caremark, commercial members can now get at-home Covid-19 tests at no cost by purchasing FDA-approved tests through participating pharmacies. For a list of the pharmacies, click here. Members must visit the pharmacy in person, take the test to the pharmacy counter and present their member ID card.
If you choose to purchase a test outside of the network of pharmacies, you can submit a request for reimbursement through Caremark.com.
When submitting reimbursement requests through the Caremark portal, a member attestation will be required. The attestation confirms that the at-home COVID-19 test is for personal use and not for resale. (PACIFICSOURCE.COM)
Reimbursement checks will be mailed from CVS Caremark.
Providence Health Plan
Providence Health Plan does not currently have a FAQ for at-home Covid-19 test information. However, they do have a Covid-19 At-Home Testing Member Reimbursement Form that you can access by clicking here.
To be eligible for reimbursement, you need the following:
- An FDA-approved test
- Have symptoms of or be exposed to a positive Covid-19 patient
- A receipt of purchase
To see Providence Health’s Covid-19 Testing resource page, click here.
Regence
Regence’s Covid-19 resource page states that all qualified members over the age of two can receive up to eight at-home covid tests per member per month. Each test will need diagnostic reasons due to having symptoms of being exposed to a positive Covid patient.
To get an at-home test with no upfront cost, you must visit an in-network pharmacy and take the test to the pharmacy counter or online so that they can bill your insurance directly. To find in-network locations click here.
If you purchase a test out of network, you will be reimbursed. The tests must be FDA-approved for diagnostic use, and you must have a copy of your receipt. You can submit a claim either online or by mail and will be reimbursed up to $12 per test. To submit your reimbursement claim, click here.
Medicare members do not qualify for the same mandate. To learn more about your coverage, click here.
Tests purchased before January 15, 2022, are not eligible for reimbursement.
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:
- Biden-Harris Administration Requires Insurance Companies and Group Health Plans to Cover the Cost of At-Home COVID-19 Tests, Increasing Access to Free Tests | HHS.gov
- From when to test to how to get one, here’s what to know about COVID-19 testing kits (yahoo.com)
- Health insurers must cover your at-home Covid test costs as of January 15 (cnbc.com)
Hyperlinks included in the article:
- https://www.bridgespanhealth.com/member/health-lifestyle/coronavirus-covid-19
- https://www.bridgespanhealth.com/sso/prime/pharmacy
- https://beonbrand.getbynder.com/m/6aa3f7327f73b917/original/Prescription-Drug-Claim-Form-BSH.pdf
- https://healthy.kaiserpermanente.org/oregon-washington/health-wellness/coronavirus-information/testing
- https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/forms/member-reimbursement-covid-claims-form-wa-en.pdf
- https://healthy.kaiserpermanente.org/oregon-washington/health-wellness/coronavirus-information/testing
- https://www.modahealth.com/community/covid-19/at-home-test-reimbursement-faq
- https://memberportal.navitus.com/micro-sites/pharmacy-pricing/moda?entrypoint=pharmacy&type=standard&group=MOOX39424OR1610001
- https://www.modahealth.com/-/media/modahealth/site/shared/forms/ModaHealth-OTC-COVID-19-AtHomeTest-Pharmacy-MemberReimbursementForm.pdf
- https://www.modahealth.com/-/media/modahealth/site/shared/forms/ModaHealth-OTC-COVID-19-AtHomeTest-Pharmacy-MemberReimbursementForm.pdf
- https://www.modahealth.com/-/media/modahealth/site/shared/forms/ModaHealth-OTC-COVID-19-AtHomeTest-Medical-MemberReimbursementForm.pdf
- https://blog.pacificsource.com/home/covid-19-updates/covid-19-at-home-test-kits/
- https://pacificsource.com/members/prescription-drug-information/find-a-pharmacy
- https://www.caremark.com/covid19-otc
- https://www.providence.org/services/covid-19-testing
- https://www.regence.com/member/health-lifestyle/coronavirus-covid-19
- https://account.regence.com/sso/prime/pharmacy
- https://beonbrand.getbynder.com/m/613544d044a20255/original/Prescription-Drug-Claim-Form-OR-CC.pdf
- https://www.regence.com/medicare/health-lifestyle/coronavirus-covid-19#How-do-I-get-a-free-at-home-over-the-counter-OTC-COVID-19-test-
