There are two kinds of tests available for COVID-19. A viral test will indicate a current infection. An antibody test might tell if you had an infection in the past.
FREE AT-HOME COVID-19 TESTS
The federal government has provided free at-home COVID-19 tests when funding has been available. Please visit COVIDtests.gov to check current availability.
REIMBURSEMENT FOR OVER-THE-COUNTER COVID-19 TESTS
On January 10, 2022, the Biden Administration released new guidance requiring health plans to reimburse covered individuals for over-the-counter (OTC) COVID-19 diagnostic tests. This policy went into effect on January 15, 2022, and is applicable through the end of the public health emergency on May 11, 2023. Starting May 12, 2023, there will be no coverage for OTC COVID-19 home tests. Members may use their Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to purchase these OTC tests.
Coverage is limited to eight tests per covered individual per 30-day period for OTC rapid antigen diagnostic tests. Tests must be purchased from pharmacies, retail stores or online retailers. Tests must be for personal use, not for employment purposes, have not or will not be reimbursed by another source and may not be resold. Specifically, Blue KC may disallow reimbursement for tests that are purchased by a participant, beneficiary, or enrollee from a private individual via an in-person or online person-to-person sale, or from a seller that uses an online auction or resale marketplace. OTC COVID-19 tests purchased prior to January 15, 2022, are not eligible for reimbursement.
Tests must be authorized or approved by the FDA. For a list of EUA authorized tests, go here and enter OTC into the list search box located under the article titled Individual EUAs for Antigen Diagnostic Tests for SARS-CoV-2 and above the table. The list may be subject to change. Please note, tests must be self-administered and self-read. Any COVID-19 test that requires a healthcare provider to administer or read is not eligible under this OTC benefit but may be eligible under your medical benefits.
Members who purchase OTC COVID-19 tests and pay out-of-pocket can be reimbursed as described below. Additional tests are limited to eight per 30-day period per member. You will be reimbursed for 100% of the cost of the test. Sales tax and delivery charges are not covered and will not be reimbursed. Please use this online form, or this PDF form (which can be emailed or printed and mailed) to request reimbursement for tests. Please note the reimbursement eligibility requirements, including the list of FDA-approved tests, listed at the top of the form. If members choose to use their HSA or Section 125 plan to pay for OTC COVID-19 tests, they cannot submit those tests for reimbursement due to IRS rules.
Members who do not have pharmacy benefits through Blue KC should contact the customer service number listed on your pharmacy benefits ID card to inquire about test reimbursement.
Blue Medicare Advantage members visit MedicareBlueKC.com/covid19 for information about free at-home COVID -19 test.