COVID-19 testing & coverage
Get at-home or in-person COVID-19 tests
- Member Cost-Sharing Update: If you are enrolled in a high-deductible health plan, the Internal Revenue Service requires COVID-19 testing and treatment to apply to the deductible starting with your plan's 2024 coverage effective date. If your coverage effective date was January 1, 2024, this requirement will take effect January 1, 2025. Please see below for details.
- Coverage Update: Over-the-counter, at-home tests are no longer covered as of May 12, 2023. The federal public health emergency ended on May 11, 2023.
Free COVID-19 tests
There are several federal and state programs for free COVID-19 testing.
Free at-home rapid COVID-19 tests may be ordered from the federal government. Visit www.covidtests.gov to place your order and to learn about options for low- or no-cost COVID 19 tests from the federal government.
Free at-home rapid tests may also be available at community health centers and Medicare-certified rural health clinics.
There may also be state and local programs in place for free COVID-19 testing, as well. In addition to the state resources listed here, look to your local board of health or your city or town website for more information.
In-person COVID-19 tests and COVID-19 treatment
We cover in-person PCR (polymerase chain reaction), antigen and antibody laboratory testing and COVID-19 treatment consistent with federal and state guidance. The end of the federal COVID-19 public health emergency on May 11, 2023 and recent IRS guidance may impact member cost sharing for COVID-19 PCR, antigen and antibody tests and COVID-19 treatment. Please review your coverage information at the links below.
*Note: You’re a commercial member if you have coverage through an employer, buy coverage through a public health care exchange or buy coverage directly from us (except Medicare Supplement and Medicaid plans).
COVID-19 coverage must be medically necessary, as determined by a health care provider, in accordance with current CDC and state public health department guidelines.
COVID-19 PCR tests that are laboratory processed and either conducted in person or at home must be ordered or referred by a provider to be covered benefits. We will not cover or reimburse you for these tests when you order them yourself, including when you order using an online self-completed questionnaire. Testing is not covered solely for general workplace health and safety, public health surveillance or for other purposes not primarily intended for a member’s individual COVID-19 diagnosis or treatment. Diagnostic coronavirus testing required as a condition of travel inside or outside of the United States is not covered.
Diagnostic testing required by your provider for surgical or other medical procedures is medically necessary and covered, including if you are pregnant or an expectant parent and testing is required prior to admittance to a delivery facility. As always, coverage is only available to health plan members.
Updates to our current COVID-19 testing and treatment policies will be published to this site as they become available.
Over-the-counter, at-home COVID-19 tests
Update: The federal COVID-19 public health emergency ended on May 11, 2023. Effective May 12, 2023, over the counter, at-home COVID-19 tests will no longer be covered under the pharmacy or medical benefit, except for Medicaid members as outlined below.
Commercial and Direct members
When purchased between January 15, 2022 through May 11, 2023*, and when submitted within one year of purchase, we will cover the cost of up to eight over-the-counter, at-home COVID-19 tests per member, per month as further described below. We will pay only for tests that are approved by or granted emergency use authorization by the FDA, are intended for individualized diagnosis or treatment of COVID-19 (not for resale) and are not for employment purposes.
- Commercial HMO, PPO or POS and Direct members who purchased at-home tests out-of-pocket can submit a form for reimbursement through OptumRx, our pharmacy benefit manager. Members can submit an online reimbursement form to OptumRx for any tests purchased on or after January 1, 2023. Please see the form for instructions. Members submitting reimbursement for tests purchased before this date will need to submit for reimbursement from CVS/Caremark.
- Commercial and Direct members who paid for at-home tests out-of-pocket between January 15, 2022 and December 31, 2022 can also submit a form for reimbursement through CVS Caremark. Members can submit an online reimbursement form through their accounts on www.caremark.com, or they can complete a paper reimbursement form and mail it with their receipts to CVS Caremark. Please see the forms for instructions and details.
*Please note, self-insured employer groups may choose to administer this benefit through their pharmacy benefit manager. Members of self-insured groups should follow up with their employer to confirm their coverage options.
Medicaid members
MA Together, RITogether, Senior Care Options and Unify members can obtain coverage for over-the-counter tests through their pharmacy benefits. Members should visit an in-network pharmacy to purchase the tests with no upfront cost.
Please note:
- Starting June 5, 2023 and through September 30, 2024, RITogether members will be covered for six over-the-counter COVID-19 tests per month.
- Starting in July 2023, MA Together, Senior Care Options and Unify members will be covered for two over-the-counter COVID-19 tests per month. If more than two tests are medically necessary, we will cover them with prior authorization.
Medicare Advantage members and Medicare Supplement members
Update: Coverage for over-the-counter, at-home COVID-19 tests ends after May 11, 2023.
Medicare coverage of over the counter COVID-19 tests ended on May 12, 2023.
Free at-home rapid COVID-19 tests may be ordered from the federal government. Visit www.covidtests.gov to place your order and to learn about options for low- or no-cost COVID-19 tests from the federal government.