Yes, the Federal Government passed a law that went into effect on Jan. 15, 2022, requiring insurers to reimburse members for the purchase of up to eight at-home COVID-19 tests in a 30-day period. BCBSKS is partnering with our pharmacy benefit manager, Prime Therapeutics (Prime), to help make this process simpler.
How to receive reimbursement: You can go to any pharmacy counter in Kansas and ask for a COVID-19 test. Show the pharmacy representative your BCBSKS ID card and, depending on your plan coverage, you will either receive a test at the counter for no charge ($0) or you will pay for the test and submit for reimbursement here with a copy of your receipt. If you happen to pick up a test off the shelf of a local store or order one through an online retailer, save your receipt and you can submit for reimbursement here, up to $12 per individual test*.
*Many tests are sold two in a box. In those cases, you would receive up to $24 reimbursement, up to $12 per test. If you have multiple tests on one receipt that you want to credit to different members of your insurance plan, you must submit a separate claim form for each member and include a copy of the receipt with each form. Click here for an example of how to fill out the claim form.
Q: Are all at-home tests eligible for reimbursement? The Federal Government has limited the reimbursement of at-home COVID-19 tests to those that have received emergency use authorization from the Food and Drug Administration. Currently, that includes the following:
Additionally, any tests that were prescribed by a physician or require a lab to read the results, are not included in the at-home test reimbursement. If you are purchasing at-home tests for required employment testing, those are also not covered.
Q: What pharmacy can I go to get an at-home test at no charge? BCBSKS members can go to any in-network or out-of-network pharmacy to get a COVID-19 at-home test. However, depending on your Plan coverage, if you would like to get a test for no charge at the pharmacy counter, you must use either Walmart, Sams Club or Hy-Vee pharmacies. For at-home tests that are purchased off-the-shelf at any other pharmacy, members will need to submit a reimbursement claim with a copy of your receipt. Pharmacies are experiencing staffing shortages nationwide. You may encounter a pharmacy that will give you a test but send you to check out at a register as they do not have adequate staffing to process your claim. Be sure to save your receipt and submit this claim form to receive reimbursement. BCBSKS will only reimburse up to $12 per test.
Q: What if the test I purchase costs more than $12? It is important to note that at-home testing should not cost more than $12/test. Some retailers may try charge more due to the high demand for tests, but BCBSKS will only reimburse up to $12 per test.
Q: Am I guaranteed a test? Unfortunately, the guidance passed by the Federal Government does not guarantee you a test. It just guarantees reimbursement if you find one to purchase.