What to know about over-the-counter (OTC) at-home COVID-19 test coverage
Under new Federal mandates, your plan may cover COVID-19 tests at little or no cost during the national public health emergency period.
We're here to keep you informed on how to get over-the-counter (OTC) at-home COVID-19 tests. Review the information here to learn about options available to purchase OTC at-home COVID-19 tests and how to be reimbursed for any purchases.
Who is eligible?
Members whose pharmacy plan covers at-home COVID-19 tests authorized by the Food and Drug Administration (FDA).*
The information below does not apply to members whose commercial plan covers at-home COVID-19 tests under their medical plan, and members who have Medicare, Medicare Supplement or Medicaid. Please contact your health plan or state agency for specifics on coverage of at-home COVID-19 test kits. Coverage rules may vary by state and plan.
What tests are covered?
Most at-home COVID-19 test kits authorized by the FDA are covered. Look for an FDA Emergency Use Authorization label on the package. The most common tests are BD Veritor™, CareStart™, Celltrion DiaTrust™ COVID-19 Ag Rapid Test, Flowflex™, i-Health®, INDICAID™, InteliSwab™, MaximBio ClearDetect™ COVID-19, On/Go™, or Pilot™ COVID-19 AT-Home test kits (Roche).
How many tests can I purchase each month?
You can get up to 8 FDA-authorized at-home COVID-19 tests per covered member, per month. No prescription is required.
Where can I buy at-home OTC COVID-19 tests for a $0 copay?
Go to the pharmacy counter at Kinney Drugs, Rite-Aid (including Bartell Drugs), Sam's Club, Walgreens (including Duane Reade) or Walmart Pharmacy. Show your member ID card and ask to have your OTC at-home COVID-19 test(s) submitted to your plan for coverage. No copay is required for this purchase.
Eligible members can shop at Optum store. Requires sign in to your OptumRx account here. Then find Get at-home Covid-19 tests with $0 copay. Get free standard shipping on orders to all 50 states. Click the order now link.
How do I get reimbursed for OTC COVID-19 tests that I purchased?
You will need your purchase receipt(s) and your member ID to complete your reimbursement form here. A separate form must be submitted for each covered member. If you prefer, you can also print a reimbursement form here and mail it to us.
*Tests must have a purchase date on or after January 15, 2022.
*Plan covers up to 8 tests per covered member, per month (up to $12 per test).
Can I get reimbursed for an at-home COVID-19 test paid using my FSA or HSA funds?
No. You are not able to get reimbursed by your health plan if you used funds from a health flexible spending arrangement (FSA) or an account-based plan, such as a health reimbursement arrangement (HRA) or health savings account (HSA) to pay for a test(s) on or after January 15, 2022.
What if I already submitted a reimbursement for a test(s) purchased using my FSA or HSA funds?
Contact your FSA , HSA or account-based plan, to assist you with correction steps to take if you received a reimbursement from your health plan for an at-home OTC COVID-19 test(s).