The Biden-Harris administration announced that, beginning Jan. 15, 2022, health plans must cover the cost of at-home over the counter (OTC) COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration (FDA). This means that colleagues and dependents covered under a Trinity Health medical/prescription drug plan will be able to get FDA authorized at-home OTC tests at no cost when obtained at an OptumRx participating retail pharmacy, including Trinity Health pharmacies (where available). Each covered family member is eligible to receive up to eight tests covered per 30 days.
To have an at-home OTC COVID-19 test covered at no cost on or after Jan. 15, 2022, members can obtain an FDA authorized test at any OptumRx network retail pharmacy. Test supply will vary and may be limited by location. To keep out-of-pocket costs to a minimum, here is what members need to know:
- Qualifying tests include FDA authorized OTC COVID-19 antigen or molecular tests only.
- At the pharmacy, members should present their OptumRx card.
- Not all pharmacies can process OTC products through the prescription drug plan so members may be required to purchase an OTC COVID-19 test and submit for reimbursement through OptumRx. Members will need to provide an itemized receipt with the reimbursement request which could take up to 30 days to process. Reimbursement process details will be shared through the COVID Read newsletter as soon as they are available.
- Members who purchase an OTC COVID-19 test at a non-network location on or after Jan. 15, 2022 may submit for reimbursement to OptumRx for up to a maximum of $12 per test.
- Colleagues who have coverage through a non-Trinity Health medical/prescription drug plan should wait for instruction from that plan.
- OTC COVID-19 tests obtained prior to Jan. 15, 2022 are not eligible for reimbursement.
Information for colleagues enrolled with Blue Care Network (BCN) or Kaiser only
Colleagues enrolled with Blue Care Network (BCN) or Kaiser may purchase FDA authorized at-home OTC COVID-19 tests, save their itemized receipts, and submit for reimbursement through their medical plan administrator.
Please look for additional information about this update in the COVID Read newsletter soon.
For access to all posted COVID-19 documents, visit the COVID-19 Resources page.
For the latest updates on the COVID-19 vaccine, visit the COVID-19 Vaccine page.