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.
What are the highlights of the at-home COVID-19 test purchased on or after January 15, 2022?
- Beginning February 1, 2022, Surest health plan members will only be able to use their Pharmacy benefits to access 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 per calendar month.
- Surest members will be able to obtain tests at specific Preferred Retail pharmacies with no up-front cost and will not have to submit a form for reimbursement. 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 plans preferred retail pharmacy, to receive reimbursement, they must submit a purchase receipt(s) or invoice showing a purchase date of January 15, 2022, or after, the name of the test, and the cost of the test **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 up to $24 (up to $12 for each test).
- Members can search Benefits.Surest.com for the specific over-the-counter (OTC) at-home COVID-19 diagnostic test they wish to purchase to be linked to OptumRx.
Member specific coverage
Which OTC at-home COVID-19 tests are part of this program?
How many COVID-19 tests will be allowed per member, per month?
How can I purchase approved over-the-counter (OTC) at home COVID Test kits without any out of pocket expense or having to submit a claim?
From a Preferred Pharmacy Retailer: Surest health plan members with an OptumRx logo displayed on their member ID card can visit an in-store pharmacy counter at an Optum Rx Preferred Retailer for no out-of-pocket cost with their member ID. A Preferred Retailer is a pharmacy that OptumRx has made arrangements with to provide OTC at-home COVID-19 tests with no out-of-pocket costs to Surest members. OptumRx is working to add additional Preferred Retailers.
- Preferred Retailers
- Find a Walgreens near you (includes Duane Reade locations)
- Find a Walmart Pharmacy near you
- Find a Sam's Club near you (You may still purchase OTC at-home COVID-19 tests at the in-store Sam’s Club pharmacy counter without a Sam’s Club membership. Only Sam’s Club members can make purchases at a front-of-store checkout.)
- Find a Rite Aid Pharmacy near you
- Find a Bartell Drugs near you
- Find a Kinney Drugs near you
- Be sure to have your member ID card with you and purchase your test(s) at the pharmacy counter.
How can I purchase approved over-the-counter (OTC) at home COVID-19 test kits and receive 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 plans preferred retail pharmacy, they may submit purchase receipt(s) for reimbursement to OptumRx 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 up to $24 (up to $12 for each test).
- Members can search Benefits.Surest.com for the specific over-the-counter (OTC) at-home COVID-19 diagnostic test to be directed to OptumRx.
From the Optum Store: Alternatively, Surest health plan members with an OptumRx logo displayed on their member ID card can order directly from the Optum Store, by logging into the OptumRx member portal, for no out-of-pocket cost.
Steps to accessing COVID OTC Tests on the Optum Store:
- Log into your personalized OptumRx.com account, or follow the instructions to create a new account on OptumRx.com. For future reference, a link to OptumRx.com can be found in the resource section of Benefits.Surest.com.
- Note: if your member ID card includes a separate “RX ID”, use this to create your account.
- If your card only lists one member ID, use your Surest member ID from your insurance card.
- View sample ID card.
- Once logged into your personalized OptumRx account, navigate to the section titled **"Get at-home COVID-19 tests with $0 copay*"**and click the order now button.
- After selecting the default test on the store's site, you will be directed to create an Optum Store account to complete the transaction. Once you create a username and password, you can proceed to check out. To receive free shipping, select at least 2 test kits with your order.
- Note: Orders placed through the Optum Store are counted toward the limit of 8 tests per member per month.
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.
Can I purchase an OTC at-home COVID-19 test that costs more than $12?
Are there state-specific differences that apply to the reimbursement of at-home over-the-counter (OTC) COVID-19 test?
Will the result of COVID-19 test have to be reported in order to receive reimbursement?
How will a member receive reimbursement?
How long will it take for a member to receive reimbursement?
Can members submit a COVID-19 home test purchased prior to January 15?
Is a physician order or clinical assessment required for reimbursement for COVID-19 home test?