February 3, 2022
On January 15, 2022, the
federal mandate requiring health plans to cover member-purchased over-the-counter
(OTC) COVID-19 tests went into effect. These are for diagnostic purposes only
and use a specific claim
form. Members may purchase up to 8 tests per covered
member per 30-day period. The tests are covered as individual tests and not as
a package (i.e., most tests come as a package of 2). Read our FAQ information on which tests are covered and get a
link to the claim form.
COVID-19 diagnostic tests
handled in a provider’s office should continue to be billed as a medical service
and shouldn’t use the member-submitted form. For information on coding
diagnostic tests, read our COVID-19 FAQ.
The federal government also
released information on their test kits, which can be ordered now through covidtests.gov.
There is a limit of 4 tests per household.