COVID-19 OTC At-Home Testing FAQs

OTC at-home COVID-19 tests may be covered under your prescription drug plan unless your employer has specifically opted-out. Prescription-only, laboratory, prescribers’ office, and clinic-based COVID-19 tests are not included in coverage. Coverage is only available for personal use. You should not request reimbursement from the prescription drug plan for OTC at-home COVID-19 tests for non-personal use.

No prescription is required for OTC at-home COVID-19 tests.

There is no copay for OTC at-home COVID-19 tests if your pharmacy is able to submit a claim electronically to Serve You Rx.

NOTE: There may be circumstances where (1) a test kit available for sale at your pharmacy is not listed in the pharmacy system or (2) your pharmacy is otherwise unable to electronically submit a claim for the kit to Serve You Rx. In these cases, you should save your cash register receipt and submit it to Serve You Rx for reimbursement, via the Direct Member Reimbursement process. Under the Direct Reimbursement Process, you must submit a test kit receipt with the OTC At-Home COVID-19 Test Kit Reimbursement Form.

There is a limit of eight tests per month per plan member.

In order to obtain OTC at-home COVID-19 tests without upfront payment, you must go to an in-network pharmacy. The pharmacy must be able to electronically submit a claim to Serve You Rx for the test kit in question.

NOTE: There may be circumstances where a commercially available OTC at-home COVID-19 test kit is not listed in the pharmacy’s system or is otherwise unable to be electronically billed through your prescription benefit. Under these circumstances, you should seek reimbursement through the Direct Member Reimbursement process. Under the Direct Reimbursement Process, you must submit a test kit receipt with the OTC At-Home COVID-19 Test Kit Reimbursement Form.

In order to obtain OTC at-home COVID-19 tests without upfront payment, you must go to an in-network pharmacy. Tests purchased at other locations or purchased out-of-pocket at a network pharmacy can be submitted for reimbursement through the Direct Member Reimbursement process.

Under the Direct Reimbursement Process, you must submit a test kit receipt with the OTC At-Home COVID-19 Test Kit Reimbursement Form.

FDA-authorized tests are included as part of the program. Prescription-only, laboratory, prescribers’ office, and clinic-based COVID-19 tests are not included in coverage.

You can purchase OTC at-home COVID-19 tests that cost more than $12, but you will only be reimbursed a maximum of $12 per test.

Serve You Rx will mail a check to the address listed on the completed OTC At-Home COVID-19 Test Kit Reimbursement Form.

Typically, reimbursements are dispersed within 10-12 business days. To help avoid delays, be sure to thoroughly complete the OTC At-Home COVID-19 Test Kit Reimbursement Form with all requested information.

Yes.

No.

No. The federal government launched a website where each household can request a one-time shipment of four free OTC at-home COVID-19 tests. Tests obtained from the federal government do not count towards the eight tests per month. For more information about this program, visit covidtests.gov.

For more information and answers to clinical questions, please refer to the CDC website (cdc.gov), your local health authority or public health department, your doctor, or your local pharmacist.