Coverage of over the counter (OTC) COVID 19 testing:
The Plan has arranged for a “direct coverage option” with CVS Caremark that will allow participants and dependents to obtain test kits for free from any Caremark network pharmacy. Alternatively, participants and dependents can purchase kits from out-of-network retailers or out-of-network pharmacies and submit claims for reimbursement.
Here is how you can get a covered test:
- At a Caremark Network Pharmacy ($0 up-front cost to you): Purchase a test through a Caremark network pharmacy at the pharmacy counter. Note: this applies to pharmacies in the Caremark network and not just CVS pharmacies. Please log onto Caremark to see a list of network pharmacies. Just go to the pharmacy window and show your CVS Caremark ID card. If you do not purchase the test at the pharmacy counter, you can purchase it at the front of the store, but in that case you will have to pay up front and submit a claim for reimbursement as described below.
- Not at a Caremark Network Pharmacy (you must pay up-front and be reimbursed): If you do not purchase a test at a Caremark network pharmacy, you must submit a claim form, attestation, and your valid receipt for the test through the Caremark app, online or mail. More information can be found by logging onto www.caremark.com.
Alternate resources for free COVID test
- Order up to four free tests from the federal government at www.covidtests.gov.
- Local Health Centers at findahealthcenter.hrsa.gov/
Reimbursement for OTC COVID-19 tests
- The test must be an FDA-approved at-home use test purchased on or after January 15, 2022.
- The test must be for diagnostic or treatment purposes and not employment purposes.
- Up to 8 tests per covered individual per rolling 30-day period will be covered.
- You must attest that the test is for personal use, not to be resold or distributed, not for employment purposes and will not be reimbursed by any other source.
- If you do not purchase a test at a Caremark network pharmacy:
- You must submit a claim form, attestation and a valid receipt of purchase from a retailer or pharmacy. The receipt must show the name of the product, the date of purchase and the price.
- Reimbursement will be limited to $12 per test (once the Plan makes available a direct-to-consumer shipping option with direct coverage and no up-front cost).
CVS Health National Network Participating Retail Pharmacies