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UPDATE: COVID-19 over the counter testing reimbursement

By January 25, 2022February 27th, 2023Featured Health & Well-being Health Insurance

Access to COVID-19 testing is critically important as we work to limit the spread of COVID-19 variants. Independence Blue Cross (Independence) is implementing the Biden administration’s over-the-counter (OTC) testing program finalized earlier this month.

Beginning January 15, 2022, and until the end of the Public Health Emergency, Independence will cover up to eight FDA approved OTC COVID-19 tests per calendar month as directed by the Biden administration’s program.

Individuals, Families, and Group customers with FutureScripts (OptumRx) can use this coverage in three ways:

  • Point of Sale: Members can visit any Walmart, Sam’s Club, or Rite Aid location, get an OTC COVID-19 test kit off the shelf, and check out at the pharmacy counter with $0 out-of-pocket costs. Members must present their member ID card and ask to have the OTC test submitted to OptumRx.
  • Ordering Online: Starting in early February, members will be able to order OTC COVID-19 tests from OptumRx using an online form that will be available next week.
  • Member Reimbursement: If members purchased an OTC COVID-19 test on or after January 15, 2022, they can submit for a reimbursement of up to $12 per test. Members should complete the OptumRx Over-the-Counter Test Reimbursement Form and include their receipts. Members need to submit a separate claim form for each family member.

Independence and OptumRx do not control the supply of at-home tests. Coverage is available when the pharmacy offers OTC COVID-19 tests and has them in stock. For members with pharmacy coverage through another company, they should contact the phone number on their prescription drug card for information on how OTC COVID-19 test coverage applies.

The Biden administration has also set up a website where people can order four free COVID-19 rapid tests per household. These tests can be ordered by visiting covidtests.gov.

In addition, Independence continues to cover FDA-approved COVID-19 diagnostic tests, such as PCR tests, with no cost share for any member when ordered or administered by a health care provider following an individualized clinical assessment. Independence does not cover tests that are needed for return to work, a condition of employment, return to school, or travel.

Additional information about COVID-19 testing and vaccines can be found in these FAQs.