Blue Shield will cover the costs of At-Home COVID-19 tests. CASHIC (the Health Insurance consortium which SGCSD is part of) is currently a non-migrated Highmark client and will be migrated to the Highmark platform effective July 1st.
As you are all aware, the federal Departments of Health and Human Services, Labor, and Treasury published new guidance requiring commercial health insurance providers and group health plans to cover the cost of FDA-approved, rapid, over-the-counter (OTC) COVID-19 tests during the federally determined public health emergency.
According to the guidance:
- Members with employer-sponsored or individual health insurance coverage can be reimbursed by their group health plan for OTC COVID-19 tests.
- Members do not need a prescription to be reimbursed for OTC COVID-19 tests.
- To be reimbursable, these tests must be FDA approved. A list of FDA-approved tests is available here.
- OTC testing used for employment or school purposes is not covered under this mandate and is not eligible for reimbursement under the medical plan.
- Members can be reimbursed for up to eight FDA-approved OTC tests per month.
- This mandate is effective January 15, 2022 and will continue through the COVID-19 public health emergency period.
As a result, we have outlined our test reimbursement process. For OTC tests purchased on or after January 15, 2022, members can submit a claim form with a copy of their test receipt (showing the date of purchase) and universal product code (UPC) found on the test box to us online or by mail.
A separate claim form must be submitted for each member. The websites and forms to do this will be different if your group has migrated onto the Highmark claims processing platform.