Feb 24, 2022
Health Net members can receive COVID-19 home tests several ways.
How can members get free at-home COVID-19 tests?
If members have pharmacy coverage as part of their Health Net plan, they can get an over the counter (OTC), FDA-approved, EUA at-home COVID-19 test at no cost by visiting one of Health Net's in-network retail pharmacies.
Remember, members must get the test from the pharmacy itself. If they pay for the test at the normal register, then they will need to submit a medical claim form to get reimbursed.
Are there tests not covered through pharmacy?
COVID test kits that are not covered include:
- Kits that have to be sent to a lab (collection kits)
- Kits that are not indicated as "OTC"
- COVID kits obtained outside of the United States
How can a member with a Health Net group medical plan with prescription coverage through another company receive an at-home COVID test for free?
Members can check with their pharmacy to see if they can bill the vendor through their pharmacy system. The member can then get an OTC at-home COVID-19 test at no cost. They can also purchase an OTC FDA-approved, EUA at-home COVID-19 test and be reimbursed by Health Net for the cost of the test by completing and submitting a Health Net medical claim form.
If a member bought an at-home COVID-19 test on their own, will they be reimbursed?
Yes. If a member bought an OTC FDA-approved, EUA at-home COVID-19 test at any place outside of our in-network pharmacies (e.g., Amazon, grocery store, drug store, etc.), they will be reimbursed for the cost of the test kits (up to $12 per test).
Purchase an at-home test that is on the FDA-approved EUA list. Tests available without a prescription will include "OTC" (for over-the-counter at-home tests) in the Attributes column.
Complete and submit a separate claim form (English | Spanish) for each member. Complete Section 1 and Section 2 of the claim form. For Section 3, include this information in the fields as follows:
- The store where they bought the test kit (Amazon, grocery store name, drug store name, etc.)
- The address of the store if applicable.
- Write "COVID-19 Home Test" and the number of tests.
- The date they purchased the kit(s).
- The amount being asked for reimbursement.
Include a copy of the receipt with the claim. Write or circle on the receipt the name of the OTC COVID Test Kit and the UPC Code found on the box.
If the member bought an FDA-approved EUA at-home COVID-19 test on Amazon, how do they show their proof of purchase?
Print an image of the digital receipt and submit it along with the claim form. If the member can't provide a digital receipt, they may put the order or invoice number for the purchase on the claim form. This is for proof of purchase and tracking.
How will a member be reimbursed?
The member will be reimbursed based on federal guidance set on January 10, 2022, which states:
- The cost of the at-home test – up to $12 per test
- Maximum of 8 tests per covered member in a 30-day period
- A single testing kit box that includes two tests would count as two (e.g. $12 x 2 = $24)
If they purchased a physician ordered, FDA/EUA approved test before January 15, 2022, Health Net will reimburse the member when the claim form is turned in based on what they paid.
Will Health Net limit the number of tests that a member can get for free?
Yes. Health Net will cover 8 OTC FDA-approved, EUA at-home COVID-19 tests purchased over-the-counter per covered member in a 30-day period. This follows the federal guidance released on January 10, 2022.
