At-Home COVID Test Reimbursement: From Blue Shield to Kaiser, How to Get Your Health Insurance to Pay You Back

As of Jan. 15, people with private health insurance can get reimbursed by their insurer for the cost of up to eight at-home COVID tests per month.

This program applies only to at-home tests purchased on or after Jan. 15, and covers eight free tests per covered individual per month. “That means a family of four, all on the same plan, would be able to get 32 of these tests covered by their health plan per month,” the White House has confirmed.

Skip to:

• Find your health insurer and their policy in our list
• How many COVID tests will insurance cover?
• What if you don’t have health insurance?

Remember, this reimbursement is completely different from the White House program that allows you to order free at-home COVID tests online from the federal government and the United States Postal Service. Read more about how to order those four free tests per residential address via USPS.

The two ways that reimbursement works

If you have private health insurance, how you get your reimbursement and your tests — and whether you get reimbursed after purchase or have costs covered up-front — totally depends on which insurer you have.

Each insurance company is doing this differently, so make sure you know what’s available for you according to your plan before you buy a test.

People covered by Medicare are currently not eligible to get reimbursed for at-home COVID-19 tests. However, Medicaid and Children’s Health Insurance Program (CHIP) plans are required to cover the costs of at-home tests. In California, this includes all Medi-Cal plans as well. If your Medi-Cal plan is provided by any of the major insurers we include in our guide, you can request a reimbursement by following the same format.

Some insurers will reimburse for the tests you’ve purchased

Some insurance companies, like Kaiser Permanente, Aetna and Blue Shield of California, are asking policyholders to request a reimbursement after purchasing a COVID-19 test by filling out a claim form.

These forms are usually returned by mail, and you’ll most likely find the address for where to mail it on the form itself.

These reimbursement forms request that you also submit a receipt of these purchases — so if you buy the tests at a pharmacy, be sure to keep your receipt.

Some insurers will cover the cost of your tests up-front when you buy them

Some insurance companies are choosing to cover the cost of tests at the time of purchase. For example, that’s what UnitedHealthcare is doing with a very select number of test providers, like Rite Aid and Walmart Pharmacy. If you’re covered by UHC and have Optum Rx benefits, you can show your member ID card when picking up your tests at one of these stores.

Other insurers, encouraged by the federal government, also have set up networks of preferred stores and pharmacies where policyholders can get tests with no up-front costs. If your insurer has set up a network like this, you can still buy tests from other places — but you most likely won’t be fully reimbursed, because insurance companies are only required to cover up to $12 per test if they were bought outside that network.

Remember, only some insurance companies have a network of preferred test providers. If your insurer doesn’t have one, you can go through the regular reimbursement process.

How does your health insurer handle reimbursement for at-home COVID tests?

Kaiser Permanente

How to get at-home test costs covered: Submit a reimbursement claim form by mail.

• Kaiser’s California Member Services hotline is (800) 464-4000.

Blue Shield of California

How to get at-home test costs covered: Submit a reimbursement claim form by mail.

UnitedHealthcare (UHC)

How to get at-home test costs covered: Get your costs covered up-front when you purchase through an approved test provider.

Cigna

How to get at-home test costs covered: Submit a reimbursement claim form by mail or fax.

Cigna will cover the full cost of at-home tests, regardless of whether you buy them from providers inside or outside their network.

Anthem Blue Cross

How to get at-home test costs covered: Submit a reimbursement claim form online.

• You’ll then see an electronic form that asks you for certain information, including whether you bought the test within the U.S. or abroad, the location and date of your purchase and a photo or scan of the receipt to verify your purchase.

Aetna

How to get at-home test costs covered: Submit a reimbursement claim form (but details on how are not yet available).

How many COVID tests will my insurance cover?

Each person covered in your plan is eligible for eight free tests each month. Insurance companies are quick to point out that this means eight individual tests, not eight packs of tests.

Some tests are being sold as a two-pack, where one box includes two tests. If you buy one of these boxes, your insurance will count that as two from your eight available monthly tests.

Most insurance companies are defining a “month” as a 30-day period, so it’s also a good idea to keep track of the dates of your purchases to make sure you don’t exceed the cap and miss out on a reimbursement.

What if I don’t have health insurance?

Remember, you don’t need health insurance to order four free at-home COVID tests online from the federal government and the United States Postal Service. Read more about how to order four free tests per residential address via USPS.

You can also use our guide to look for a free or low-cost COVID test near you, many of which do not require health insurance.

This story includes reporting by KQED’s Carly Severn.

This content was originally published here.