New Federal Government Program Allows Employees to Receive Free At-Home COVID Tests
A new program launched by the federal government allows for all Cook Children’s employees who receive health insurance coverage to request up to eight free at-home COVID tests a month through their insurance plan.
Insurance companies and health plans are required to cover eight free at-home tests per covered individual per month. For example, if you have four family members covered by your insurance plan, you would be able to get 32 tests per month.
As an insurance member, you have two options:
1. Over the counter: Purchase the tests on your own. Save your receipts and file a manual claim with your insurance provider. If you purchase a test, you may be eligible for reimbursement with the new outlined plan.
2. Use your pharmacy: Visit the pharmacy covered by your insurance plan. Submit the claim to your insurance provider. As a member, there is the potential of no out of pocket cost to you.
Here’s how it works:
CVS Caremark OTC COVID-19 Tests Without A Prescription Under The Pharmacy Benefit Solution
- Direct Member Reimbursement (post service reimbursement program): Reimbursement for over the counter (OTC) COVID-19 tests without a prescription after purchase, starting Jan. 15, 2022 until the end of the Public Health Emergency (PHE). Members can upload a copy of their receipt of the OTC COVID tests purchased via Caremark.com to submit for reimbursement or submit a paper claim.
- Member will be reimbursed, and the plan will pay. Once a plan meets all components of the direct coverage safe harbor, the member will be reimbursed, and the plan will pay, the lesser of (i) the full retail price paid by the Member, or (ii) the lesser of the $12 per test reimbursement limit established by the Administration in the direct coverage safe harbor.
- Direct Coverage (i.e. “Pharmacy Benefit Manager (PBM) adjudication at pharmacy point-of-service”): Plan will cover the cost of OTC COVID tests with direct reimbursement to the pharmacy and no upfront out of pocket cost for members.
- CVS Caremark will adjudicate claims at a rate comparable to the pharmacy’s U&C rate. This is for participating pharmacies. Not all Pharmacies will choose to participate.
- Quantity limit of eight tests per 30 consecutive days across both coverage capabilities.
Tests delivered to your home
Along with the tests you may receive through your insurance, a one-time order of four free tests per residential address can be requested Beginning Jan. 19, Americans can order the tests online at COVIDTests.gov. The tests will typically ship within 7-12 days of ordering.
Can these tests be used at Cook Children’s?
If you are feeling ill or showing symptoms of COVID-19, you may submit a rapid test result to the COVID-19 Center by sending your name, employee ID number, phone number to COVID-19OHS@cookchildrens.org . Then someone will contact you to complete your evaluation form.
This testing will not take the place of regularly scheduled COVID testing if you are an employee who received a vaccine exemption.
Infection Control asks that you only test if you are showing symptoms and not waste a test if you don't have any symptoms. Timing of the test is critical. Sometimes testing too early in the illness could result in a false negative.
To read more about at-home tests, click here.