At-home COVID-19 testing coverage

Thursday, January 20, 2022

Test tube with blood sample. Covid-19 virus testing kit. Coronavirus quarantine home clinical responsibility.

Effective January 15, 2022, the Biden Administration is requiring private health plans and insurance providers to cover FDA-approved over-the-counter (OTC) COVID-19 tests without needing a prescription and with no cost share to covered individuals.

TeamCare and CVS Caremark have partnered to ensure our members can obtain testing kits through direct coverage at the point-of-sale or a reimbursement process explained below. The direct coverage option is the easiest and fastest way to obtain approved OTC COVID-19 tests with no upfront costs.

Tests are limited to eight (8) per person in a 30-day consecutive period and subject to supply availability. If you purchase a kit that has two (2) tests, that will count as two (2) against the eight (8) test limit.

Additionally, the federal government is offering free at-home tests at covidtests.gov with direct delivery shipping from USPS. Orders are limited to one (1) kit per household which contains four (4) tests.

Direct Coverage Option

Members can purchase FDA-approved tests by presenting their Benefits ID card to any network pharmacy participating in the direct coverage or point-of-sale program with no upfront out-of-pocket costs. Pharmacies have the option to opt-out of this program and this option may not be available at your time of purchase.

Reimbursement Option

Members can be reimbursed for FDA-approved OTC at-home COVID-19 tests purchased at any pharmacy or vendor of choice. Requests for reimbursement for purchases made on January 15 or later can be completed through an online claim submission process available at Caremark.com or on the CVS Caremark mobile app.

CVS has provided step-by-step instructions on how to complete the reimbursement request process. You can view or download the CVS Member Reimbursement document by clicking here.

You will be required to provide a receipt as proof purchase and attest that the OTC test was purchased for personal use and not for resale or employment. Reimbursement totals may be limited and not cover the full cost of the test.