Health Plan Reimbursements for COVID Home Test Kits
Following new federal guidelines, issued on January 15, 2022, SFHSS health plans will reimburse members for rapid antigen at-home test kits for COVID-19. Rapid antigen home test results are typically available within 30 minutes.
Members may receive reimbursement for up to eight individual over-the-counter COVID-19 at-home tests per covered individual in the household per calendar month without a healthcare provider order. Each test is counted separately, even if multiple tests are sold in one package.
For health plan information on In-Person Testing, visit our COVID-19 Testing page.
Health Net CanopyCare HMO
Health Net SFHSS members can get COVID-19 Home Testing kits at no cost. The best way to get a testing kit is to go to one of Health Net’s in-network pharmacies.
If you purchase an at-home COVID-19 test at any location outside of our network pharmacies (e.g., Amazon, grocery store, etc.), Health Net will reimburse you for the cost of the test after you complete the Member Reimbursement Form.
Visit healthnet.com/COVID19 for more information.
Reimbursement will be limited up to the amount set in the federal guidance ($12, or the cost of the test if less than $12, per test per covered individual) released on January 10, 2022.
Please print an image of the digital receipt along with the member reimbursement form. If you are unable to produce a digital receipt, please put the order or invoice number for the purchase on the reimbursement form for tracking and validation.
Blue Shield of California Trio HMO, Access+ HMO, and PPO-Accolade
Blue Shield will provide coverage for at-home COVID-19 tests for personal use that were purchased on or after January 15, 2022. For more information, visit Coverage for COVID-19 testing webpage.
To be reimbursed for at-home test kits, members must submit the Subscriber's Statement of Claim form and proof of purchase receipt. The proof of purchase receipt should include the name of the retailer, including the street address, or if purchased online, the website address, date of purchase, UPC code for the at-home test kit, and the cost of the at-home test kit.
Kaiser Permanente HMO and Kaiser Senior Advantage HMO
Kaiser Permanente will reimburse members for FDA-approved rapid antigen home tests. Rapid antigen home tests are available at local drugstores or online. Kaiser Permanente will reimburse members for FDA-approved rapid antigen home tests purchased on or after January 15, 2022 by submitting a reimbursement claim online.
Visit kp.org/coronavirus for the most up-to-date information on supply, testing, and vaccinations. For more detail, visit our COVID-19 testing FAQs.
UnitedHealthcare PPO Companion Plan
UnitedHealthcare (UHC) is covering most commercial individual and group health plan members’ FDA-authorized or approved OTC COVID-19 at home tests without a doctor’s prescription or clinical assessment. UHC's COVID-19 at home test benefit includes up to 8 tests per member per 30 days.
This information applies ONLY to self-funded customers. Please contact your UnitedHealthcare account representative for additional details or questions.
UnitedHealthcare has developed and deployed a solution of Preferred Retailers for coverage of over-the-counter COVID-19 at home test kits. A Preferred Retailer is a pharmacy that UnitedHealthcare has made an arrangement with to provide over-the-counter COVID-19 at home tests at no cost to the member at time of purchase or later. The list of Preferred Retailers and their websites may be found on Preferred Retailer list. UnitedHealthcare is working to add additional Preferred Retailers.
UnitedHealthcare will provide a maximum reimbursement of $12 per test. Many COVID-19 at home tests are sold as a two-pack so that means the test pack would be reimbursed at $24 ($12 for each test). Submit a receipt online to UnitedHealthcare at myuhc.com or use the over-the-counter COVID-19 at home test reimbursement form.
UnitedHealthcare Medicare Advantage PPO
Original Medicare is not reimbursing for OTC tests and continues to cover physician ordered tests done in a lab, which is consistent with UnitedHealthcare’s Group MA policy.
UnitedHealthcare will not be covering over-the-counter home test kits for our Medicare Advantage plans.
The attached guidance, https://www.cms.gov/files/document/11022-faqs-otc-testing-guidance.pdf just came out on home test kits. For Medicare Advantage, please refer to the answer to question 14 from the CMS's Guidance on home test kit reimbursements.
Free COVID Home Test Kits from the Federal Government
To order a free at-home COVID-19 test kit from the federal government, visit https://www.covidtests.gov