Over the Counter (OTC) COVID-19 Test Kits
As part of ongoing efforts to expand Americans' access to free COVID-19 testing, the Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of over the counter (OTC), at-home COVID-19 test kits.
On Saturday, January 15, individuals with private health coverage were able to begin obtaining OTC COVID-19 at-home test kits for free. Penn State’s CVS Caremark prescription coverage will cover the cost of OTC COVID-19 at-home test kits, for those employees and their families enrolled in a Penn State health plan.
There is a limit of up to 8 OTC COVID-19 at-home test kits per covered member (meaning each covered family member) per 30 consecutive days. (If the kits contain 2 tests, then no more than 4 kits per 30 consecutive days).
- Purchase OTC COVID-19 at-home test kit AT THE PHARMACY COUNTER of a participating pharmacy, with no up-front out of pocket costs. Members will need to present their CVS Caremark ID card at point of sale to the pharmacy. If you encounter an issue at the pharmacy counter processing your claim, please rest assured that you will be reimbursed up to the mandated limit, so please keep your receipt so you can submit a claim to CVS Caremark.
- Purchase OTC COVID-19 at-home test kits at a participating pharmacy, however, if purchasing the kits NOT AT THE PHARMACY COUNTER, members will be required to pay for the kit and then must submit a claim for reimbursement, via the CVS Caremark reimbursement page. The reimbursement will be the cost of the test itself, which may not include sales tax.
- Purchase OTC COVID-19 at-home test kits at NON-PARTICIPATING PHARMACIES AND at NON-PHARMACY LOCATIONS, such as Amazon, however, the member will need to pay for the kit at the time of purchase and then must submit a claim for reimbursement. The maximum reimbursement for these tests will be $12.
Health plan enrolled employees needing further assistance in finding a participating pharmacy, reviewing the CVS Caremark COVID-19 Help Center online, or may have questions regarding a claim reimbursement, should visit CVS Caremark or contact them directly at 844.462.0203 for further assistance. CVS Caremark has confirmed that the issue some are experiencing for option #1 above is not necessarily a systemic issue, as they are seeing adjudication at some pharmacies across the network, however, not consistently. The biggest challenges being experienced are due to capacity contraints and OTC test kit supply limitations. In some cases, pharmacies may be prioritizing dispensing medications that are provided with a valid prescription and administering vaccines over adjudicating OTC tests.