COVID-19 testing FAQs
COVID-19 over-the-counter (OTC) at home testing
On January 10, 2022, the Departments of Labor, Treasury and Health and Human Services released guidance to support the Administration’s directive that health insurers and group health plans cover the cost of FDA-authorized or approved over-the-counter (OTC) at-home COVID-19 tests purchased on or after January 15, 2022.
Over-the-counter (OTC) Test Reimbursement Form
What are the highlights of the at-home COVID-19 test purchased on or after January 15, 2022?
- Beginning January 15, 2022, Surest will cover most group health plan members’ FDA authorized or approved over-the-counter (OTC) at-home COVID-19 diagnostic tests without a doctor’s prescription. This at-home COVID-19 test benefit includes up to 8 tests per member every 30 days.
- To obtain tests without up-front cost or the need to submit a form for reimbursement, Surest members can obtain tests at any in-network pharmacy counter with their member ID. These tests must be obtained directly from the pharmacy counter to avoid needing to submit a form for reimbursement.
- If a member purchases an at-home COVID-19 test at any in-store or online retailer other than the in-store pharmacy counter of their in-network pharmacy, they may submit purchase receipt(s) showing the purchase date and test cost**** **for reimbursement to Surest for a maximum reimbursement of up to $12 per test. Many COVID-19 tests are sold as a two-pack so that means the test pack would be reimbursed at $24 (up to $12 for each test).
- Members can locate their in-network pharmacy options by searching Benefits.Surest.com for a specific over-the-counter (OTC) at-home COVID-19 diagnostic test.
- Members may also order free tests from the Federal government: The Federal government has launched a national website where each household can receive a one-time shipment of 4 free OTC at-home COVID-19 tests shipped directly from covidtests.gov. For more information on this program go to covidtests.gov.
Member specific coverage
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Which OTC at-home COVID-19 tests are part of this program?
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How many COVID-19 tests will be allowed per member, per month?
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How can I purchase approved over-the-counter (OTC) at home COVID-19 test kits without any out of pocket expense or having to submit a claim?
- You may obtain an at-home COVID-19 diagnostic test at any in network pharmacy counter at no up-front cost and will not have to submit a form for reimbursement.
- Be sure to have your member ID card with you.
Direct-to-consumer: Navitus has made arrangements with select pharmacies to provide direct purchase options for $0. Shipping charges may be applicable.
Steps to accessing direct-to-consumer COVID OTC Tests through select pharmacies
- Check out Direct-to-Consumer options available through select pharmacies. Test kits are free through the following mail order pharmacies. You may be responsible for any additional shipping charges, if applicable.
- Serve You Rx (all members): Call 800-759-3203
- Costco Pharmacy (all members) *You do not need to be a Costco member
- Visit www.costco.com/home-delivery
- Select Mail Order
- Register for a new account
- Select: Fill New Prescription
- Select: “My Doctor will Call or Fax. I do not have a written prescription”
- In the Physician Info Fields:
- Enter Physicians Name: Costco Test
- Enter Physicians Phone: 800-111-1111
- Enter Physician City: Seattle
- Enter Physician State: WA
- Enter Drug Information: COVID Tests
- From the Federal government: The Federal government has launched a national website where each household can receive a one-time shipment of four free OTC at-home Covid-19 tests shipped directly from covidtests.gov. For more information on this program go to covidtests.gov.
Question:
How can I purchase approved over-the-counter (OTC) at home COVID-19 test kits and receive reimbursement?
General questions
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How do Surest members submit over-the-counter (OTC) at-home COVID-19 test costs for reimbursement?
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Can I purchase an OTC at-home COVID-19 test that costs more than $12?
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Are there state-specific differences that apply to the reimbursement of at-home over-the-counter (OTC) COVID-19 test?
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Will the result of COVID-19 test have to be reported in order to receive reimbursement?
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What if I purchased other items with my COVID-19 tests and those items appear on my receipt?
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How will a member receive reimbursement?
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How long will it take for a member to receive reimbursement?
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Can members submit a COVID-19 home test purchased prior to January 15?
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Is a physician order or clinical assessment required for reimbursement for COVID-19 home test?
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