Woman holding Covid-19 rapid test

Reimbursement Available For Over-The-Counter Covid-19 Rapid Tests

Did you know that insurance coverage has now been extended to cover at-home Covid rapid tests? Since January this year, private insurers are now required to cover the cost of rapid at-home tests when purchased over-the-counter.  

HealthPlans of NC

Health Plans of NC, Kelly Quinn

How to get your free at-home Covid-19 test

If you have a health plan, you can access free Covid test kits at home for test kits authorized by the US Food and Drug Administration (FDA). In addition, you can arrange for reimbursement after purchasing the test, or some health insurance providers have set up direct coverage. For example, if you have coverage with Blue Cross Blue Shield of North Carolina, direct coverage is available when you purchase rapid tests at in-network pharmacies. This applies if you have private health insurance or are part of an employer-sponsored plan. 

If you need to claim reimbursement, be sure to keep your receipt. If you purchase a test from a retailer or pharmacy outside your insurance provider’s preferred network, you will be reimbursed up to $12 per individual test. This is currently the case for anyone with Blue Cross Blue Shield of North Carolina and many other providers. However, each plan and insurer can differ, so it’s worth checking directly with your provider.

How many covid test kits are covered?

Health plans are now required to cover up to eight rapid tests per month, averaging around two rapid tests per week. That means you can get 32 tests each month for free for a family of four people. The coverage is applied to all private health insurers. It doesn’t apply to Medicaid-managed care or Medicare.

If you require more tests, remember there is currently no limit on the number of tests that can be covered when administered by a healthcare provider. 

How much can I be reimbursed if my provider doesn’t provide direct coverage?  

If you purchase an over-the-counter test and your plan hasn’t set up a network of preferred stores, you’ll be reimbursed the total cost for the test. Many providers are at different stages of establishing direct coverage, so it’s essential to check whether your plan is eligible for direct coverage before purchasing your test to help save you money. If you want to find out more, we recommend you contact your health insurance provider directly or contact one of our health insurance agents in North Carolina. 

Where can I find my plan’s in-network providers?

Each health plan and insurance provider, including North Carolina, has set up its network. This can include pharmacies, retailers, or online retailers where it’s possible to get free COVID-19 tests rather than submitting a claim for reimbursement. You can find out your network of preferred retailers or pharmacies by contacting your insurer or employer if you have an employer-sponsored plan.

How do I arrange for my reimbursement if I’ve already purchased my test?

Ensure you have your receipt and submit your claim to your health plan to arrange your reimbursement. If you’re unsure how to submit a claim, contact your health plan provider to learn more. You won’t need a prescription or a note from your doctor. All you need is your receipt. In addition, most claims can be made online. 

How long it takes to receive your reimbursement can depend on your provider, so it’s a good idea to ask your provider for more information. 

Can I still get free at-home Covid-19 tests if I’m uninsured?

The Federal government has purchased approximately 500 million at-home tests. Access to a free COVID test kit from the government is available to anyone, including North Carolina residents. Each household is eligible to order two sets of four free at-home tests. Delivery of this program began in January, and you can order yours online. If you don’t have insurance, you can also receive free at-home tests from some community health centers. Over 10,000 free community-based testing sites have been established across the country since the beginning of the pandemic.  

What if I purchased my test before January? 

Reimbursement and direct coverage only apply for at-home COVID-19 tests purchased on or after January 15, 2022. However, some health plans may offer reimbursement for tests purchased before this date, so contact your health plan to determine whether you can arrange reimbursement. 

How do I get an at-home, over-the-counter COVID-19 test if I’m covered by Medicare?

If you have Original Medicare, you won’t have to pay for any diagnostic tests performed by a lab if your test is ordered by a physician, pharmacist, or other authorized healthcare professional. Unfortunately, people covered under Original Medicare can’t participate in this over-the-counter kits program. However, some Medicare Advantage plans may offer coverage for at-home over-the-counter tests. Check with your plan provider for free Covid test kit options.

Do Medicaid and CHIP programs cover at-home Covid-19 tests?

Yes. Medicaid and CHIP programs are required to cover at-home Covid-19 tests. If you have Medicaid or CHIP coverage, contact your local agency for more information.

Need help or advice? 

If you have any questions about health plans in North Carolina or are looking to find the best health insurance for your needs, contact our Medicare agents in NC today. We can answer your questions about the free COVID test kit at home and discuss various plan options that best suit your needs. So get in touch today or compare plans online.

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