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To get reimbursed for a COVID test through BCBS, you'll need to follow their specific guidelines.
BCBS covers COVID testing for eligible patients, which includes those with symptoms, close contact with someone who has COVID, or those who have been instructed to get tested by a healthcare professional.
The reimbursement process typically starts with a doctor's order or a telemedicine visit.
Getting Reimbursed
You can purchase over-the-counter COVID-19 tests at retail locations, with prices averaging $12 for a single test and $24 for a double test kit.
To get reimbursed, you'll need to submit a Health Benefits Claim Form and an itemized receipt that clearly shows the purchase was for a COVID-19 OTC test.
If you don't have an itemized receipt, you can send the barcode (UPC code) from your test(s) packaging.
BCBS will reimburse up to eight over-the-counter COVID-19 tests per member on a contract per calendar month.
You can expect to receive a reimbursement check within 30 calendar days from the time your local BCBS company receives your claim form and receipts.
The check will be mailed to the Contract Holder for the amount on the submitted claim form after processing.
Reimbursement Inquiry
We will mail a check to the Contract Holder for the amount on the submitted claim form after we have processed the claim.
The check is payable to the Contract Holder for the amount on the submitted claim form after we have processed the claim.
You can expect to receive a check in the mail once your claim has been processed.
It's a good idea to keep track of your submitted claim forms to ensure you receive the reimbursement you're eligible for.
We will mail a check to the Contract Holder for the amount on the submitted claim form after we have processed the claim.
Reimbursement for Purchase
To get reimbursed, you'll need to purchase FDA-authorized over-the-counter COVID-19 tests at a retail location. You can then submit a claim form to your local BCBS company.
The claim form should include an itemized receipt that shows the purchase was for a COVID-19 OTC test. If you don't have an itemized receipt, you can send the barcode (UPC code) from the test packaging instead.
Your local BCBS company will process your claim within 30 calendar days from the time of receipt. Once your claim is processed, a check will be mailed to the contract holder.
You can download the claim form online or request one by mail by calling the number on the back of your member ID card. The check is payable to the contract holder for the amount on the submitted claim form.
OTC Test Coverage and Reimbursement
You can get up to eight over-the-counter COVID-19 tests reimbursed for each family member covered on your policy every calendar month. This is a significant benefit for those who need to test regularly.
Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter, so it's essential to check ahead of time. If this happens, you can pay for the test and then submit a claim for reimbursement.
The cost of OTC tests varies, but on average, a single test costs $12, and a double test kit costs $24. FEP will cover up to eight over-the-counter COVID-19 tests per member on a contract per calendar month.
To get reimbursed, you'll need to submit a claim, and the check will be mailed to the Contract Holder for the amount on the submitted claim form after processing.
You can get tests at no cost through various channels, including visiting covid.gov, contacting your local health department, or using your health insurance card to purchase tests at an in-network pharmacy.
Here's a breakdown of OTC test coverage and reimbursement:
Keep in mind that some pharmacies may not be able to process claims for OTC tests at the pharmacy counter, so it's crucial to check ahead of time.
Where to Buy and Purchase
You can purchase over-the-counter (OTC) COVID-19 tests at various locations, including online, pharmacies, and stores. You can find these tests at any location where they are available.
To get tests at no out-of-pocket cost, you can order them online through cvs.com or the CVS Pharmacy mobile app for store pickup. You can also go to any other in-network retail pharmacy and purchase the test kits at the pharmacy counter.
If you don't have an in-network pharmacy nearby, you can try purchasing tests at other retail locations. However, be aware that you'll need to submit a claim for reimbursement, which can take some time.
Here are some specific details about purchasing OTC COVID-19 tests:
- You can purchase up to 8 tests per family member in a 30-day period.
- To find an in-network pharmacy, you can click here or download the fepblue app.
- If you purchase tests at an out-of-network retail location, you'll need to submit a claim for reimbursement, which will be reimbursed at up to $12 per test.
You can also order free at-home COVID-19 tests from the Federal Government, with no cost or reimbursement required. However, this option is only available to every U.S. household, and you can order a maximum of four tests per household.
Insurance and Reimbursement Rules
You can get reimbursed for up to eight over-the-counter COVID-19 tests per month, regardless of where you buy them, but you need to check with your insurance company to see if they still have this rule in place.
At the start of 2022, the federal government required insurers to reimburse their members for up to eight monthly at-home COVID-19 tests, and this rule lasted for over a year until May 2023.
However, some states, like California, extended this rule for six more months until November 11, 2023.
You can expect to be reimbursed up to $12 for a single test and $24 for a double test kit, but this may vary depending on your insurance plan.
You'll need to submit a claim form and receipts to your local BCBS company to get reimbursed, and they'll process your claim generally within 30 calendar days.
A check will be mailed to the contract holder for the amount on the submitted claim form after the claim has been processed.
If you use your MyBlue Wellness Card to purchase over-the-counter COVID-19 tests, you can get reimbursed, but you'll still need to follow the process for filing a claim.
Each insurance company does things a little differently, so make sure you know what's available for you according to your plan before buying a test.
You can contact your insurer directly to find out what you're eligible for before you purchase any tests.
Blue Shield of California, for example, will reimburse up to eight over-the-counter COVID-19 tests for each family member covered on your policy every calendar month.
Tracking and Submitting Reimbursement
BCBS tracks how many tests you've requested reimbursement for, and they only reimburse up to eight over-the-counter tests for each covered family member every calendar month.
To get reimbursed, you'll need to submit a claim form with receipts, which will be mailed to the Contract Holder after processing.
The reimbursement process typically takes 30 calendar days from the time of receipt of your claim form and receipts.
A check will be mailed to the Contract Holder for the amount on the submitted claim form after processing.
Frequently Asked Questions
How to get free COVID test kits from Blue Shield of California?
Get free at-home COVID test kits for your household at COVID.gov/tests. Blue Shield may reimburse OTC test kits purchased on your own; learn more about reimbursement on their website
Sources
- https://www.fepblue.org/coronavirus-updates/over-the-counter-tests
- https://www.bluecrossma.org/myblue/at-home-covid-test-coverage
- https://www.kqed.org/news/11969300/how-to-get-reimbursed-for-at-home-covid-tests-in-2023
- https://www.kff.org/policy-watch/how-are-private-insurers-covering-at-home-rapid-covid-tests/
- https://www.fepblue.org/coronavirus-updates/coronavirus-faqs
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