AT-HOME COVID-19 TEST COVERAGE
With the end of the COVID-19 public health emergency on May 12, 2023, we've returned to our original policy for over-the-counter (OTC) COVID-19 tests, which means they won’t be covered under your medical or pharmacy coverage. They are no longer covered by the Centers for Medicare & Medicaid Services for Medicare members with Part B. However, certain Medicare Advantage members can use their OTC quarterly allowance on at-home tests.
If your employer elects to continue this coverage, you may still be eligible to receive these benefits. If you have questions, call Member Service at the number on your ID card.
You can order free at-home COVID-19 tests from the federal government and may be able to get free tests through community programs.
Over the Counter COVID-19 Test Coverage:
Commercial Members |
Medicare Members |
All U.S. Households |
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How do I know if I’m eligible? | If your employer elects to continue this coverage, you may still be eligible to receive these benefits. If you have questions, call Member Service at the number on your ID card. |
OTC tests will no longer be covered by CMS for members with Part B. Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can still buy them using their quarterly OTC allowance. If you have Original Medicare, Managed Blue for Seniors, or Medex, you'll pay out-of-pocket for OTC COVID-19 tests. |
Every U.S. household is eligible to order four free at-home, COVID-19 tests from the Federal Government. |
What am I eligible for? |
Up to eight FDA-authorized, self-administered, self-read, at-home COVID-19 tests, per member, per month. |
N/A |
Four free at-home, COVID-19 tests from the Federal Government. |
Will there be a cost? |
A select list (see FAQ below) of tests is covered at no cost when purchased at an in-network pharmacy or ordered through the CVS website at CVS.com. Any FDA-authorized, at-home COVID-19 test purchased at another retailer outside of our pharmacy network will be reimbursed up to $12 per test. |
Most Medicare members will pay out-of-pocket. Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can use their quarterly OTC allowance to buy the tests. However, if you've already met your quarterly allowance, you'll have to pay out-of-pocket for your tests until the start of the next quarter. If you have Original Medicare, Managed Blue for Seniors, or Medex, you'll need to pay out-of-pocket for at-home COVID-19 tests. |
No |
Where can I get a test at no cost? |
To get tests at no out-of-pocket cost:
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Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can still purchase OTC tests using their quarterly OTC allowance. |
Visit covid.gov |
I purchased an FDA-authorized test and paid out of pocket; how do I get reimbursed? |
FDA-authorized, at-home COVID-19 tests purchased at out-of network retail locations will be reimbursed at up to $12 per test. To submit:
If you have any questions about ordering online, call CVS from 8:30am-7:00pm EST at 1-800-SHOP-CVS (1-800-746-7287). If you have any questions about your reimbursement claim submission, call CVS Customer Care 24/7 at 1-877-817-0477 (TTY: 711). *CVS Caremark is an independent company that has been contracted to administer your pharmacy benefits for Blue Cross Blue Shield of Massachusetts. CVS Caremark is part of the CVS Health family of companies. |
Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx should follow the steps above to receive tests up front and minimize any out-of-pocket expense. Members with Original Medicare, Managed Blue for Seniors, or Medex will not be reimbursed for tests paid for out-of-pocket. |
N/A |
have additional questions? we've got answers.
Eligible members can get reimbursed for the purchase of any self-administered, self-read, at-home COVID-19 tests that have received emergency use authorization from the FDA, as well as tests that have received full FDA approval.
Commercial Members with pharmacy coverage can get the following FDA-authorized tests at no cost when purchased at an in-network pharmacy or ordered through the CVS website at CVS.com.
- BinaxNow™ COVID-19 Antigen Self-Test
- CareStart™ COVID-19 Antigen Home Test
- CLINITEST®' Rapid COVID-19 Antigen Self-Test
- COVID-19 At Home Test (Roche)
- COVID-19 Rapid Self Test (Genabio)
- CVS COVID-19 At Home Test (CVS)
- Flowflex™ COVID-19 Antigen Home Test
- iHealth®´ COVID-19 Antigen Rapid Test
- Indicaid COVID-19 Rapid Test
- InteliSwab™ COVID-19 Rapid Test
- On/Go™ COVID-19 AG At Home Test
- PILOT COVID-19 At Home Test (Roche)
- QuickVue®´ At-Home OTC COVID-19 Test
Our pharmacy network includes many retail pharmacies such as CVS Pharmacy™, Walgreens, and Walmart — as well as some local neighborhood pharmacies. Find an in-network pharmacy here. *Pharmacies not participating in this program include Kroger, Costco, and a small subset of independent pharmacies.
Find a partial list of pharmacies participating in the Medicare COVID-19 Over-the-Counter (OTC) tests initiative through through CMS here. Or go to the pharmacy's website or call the relevant pharmacy for details on participating locations and how to order.
All eligible members will be reimbursed for FDA-authorized, at-home COVID-19 tests, up to $12 per test (up to eight tests per member, per month), when they complete and submit the appropriate form below:
Commercial Members with pharmacy benefits through Blue Cross: Sign in to your MyBlue account, or create a new one, then go to Pharmacy Benefit Manager under My Medications. Look for the At-home COVID-19 test reimbursement banner at the top of the page lab, click Submit a reimbursement claim, then complete and submit the digital reimbursement form. You can also complete, print, and mail the CVS Caremark Over-the-counter, at-home COVID-19 Test Reimbursement Claim form found here. If you have any questions about your reimbursement claim submission, call CVS Customer Care 24/7 at 1-877-817-0477 (TTY: 711).
Eligible commercial members that only have medical benefits through Blue Cross: Complete and submit this form.
If there is no Rx symbol on your member ID card, your pharmacy coverage is through another carrier. Please follow up with your employer to confirm your coverage options for at-home, COVID-19 tests. If your employer confirms that you're eligible, complete and submit this reimbursement form.
No, only tests bought on or after January 15, 2022, are eligible for reimbursement.
If you're a member of the Federal Employee Program, please visit the COVID-19 Resource Center at fepblue.org.