Medicare Part D-Industry News

At-Home COVID Test KITs

As a result of the Biden administration, at-home COVID-19 tests are now available to most Americans for no upfront cost or for reimbursement. These tests can be purchased online or in-store, without talking to your doctor, and with all or some of the cost covered by private insurance.

Limitations and coverage

Members are entitled to a maximum of eight tests per 30-day period for every covered person in the household. Most test kits are being sold with two tests per package, so each individual test counts towards the quantity limit. Members will only be reimbursed for tests purchased on or after January 15, 2022.

Insurance companies have the option of assigning preferred stores and pharmacies where members can acquire tests at no upfront cost. Insurance companies are also allowing members to submit a claim for reimbursement along with the test receipt and UPC code. Each insurance company may have its own process, so it is important to confirm the conditions set forth by your specific insurance carrier. Members who purchase tests out of network can still file a reimbursement claim; however, the reimbursement will be capped at $12 per test.

Availability

Rapid COVID-19 tests are being sold in numerous places like pharmacies, Walmart, Target, and online retailers. Due to the demand brought on by the Omicron variant, there is currently a shortage of tests.  A quick call to the store or pharmacy can confirm availability of tests at that location.

Free COVID-19 test from the federal government

Effective Wednesday, January 19, 2022, free tests can be ordered at covidtests.gov. You will not be asked to provide a credit card number or pay shipping when ordering a test. Within seven to 12 days, tests are expected to ship. There is a limit of four tests per household.

Medicare

Traditional Medicare is not covering over-the-counter COVID tests; however, doctored-ordered lab tests are covered. Those with a Medicare Advantage plan need to check with their private insurer to verify if the at-home tests are covered.

 

As the situation evolves, look for updates from your specific insurance carrier to confirm if your tests are covered. If you have questions please contact your dedicated Creative Benefits, Inc. team member.