Please be advised that effective January 15, 2022, and due to a directive from the federal government, CDPHP is covering at-home COVID-19 test kits that are FDA-approved or issued an EUA by the FDA.
At this time, for all commercial members (including self-funded), we will be reimbursing for kits purchased out of pocket (up to $12 per test or $24 for a kit containing two tests).
The test kits will be covered under a group’s pharmacy benefit.
Members may obtain up to eight tests (or four kits containing two tests) per covered family member, per calendar month. For example, if the first test kit is purchased on January 15, a maximum of eight tests can be purchased by February 14.
To avoid an upfront cost, members will need to purchase the test kit at a pharmacy window or pharmacy counter of a pharmacy in the CDPHP network.
If members choose to purchase a test kit at a non-participating pharmacy or other retailer, there will be an upfront cost with reimbursement; reimbursement will require this form.
This directive currently does not include Medicare Advantage (MA) members. CDPHP will alert MA members as soon as we have updated guidance and direction from the government.
At this time, MA members who purchase test kits with a provider order can receive reimbursement as a medical claim by submitting both the script and their receipt either via paper claim or in their online member account.
Please note that effective January 19, 2022, all Americans will be able to order free rapid coronavirus tests online at COVIDTests.gov.
Additional detail is forthcoming, and we will be issuing updated guidance as often as it is received. We thank you for your cooperation.