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Disclaimer
The information in this article is current as of the date it was last reviewed. Please check with your insurance or healthcare provider for the most up-to-date information regarding submitting insurance claims and receiving reimbursement as well as test access regulations and guidelines.
COVID testing is a crucial component of our ongoing fight against the coronavirus pandemic. Now, thanks to a policy handed down from the White House, insurance companies and group health plans are required to cover the cost of at-home COVID tests and reimburse members with private coverage who purchase authorized tests on their own.
But getting that money can require jumping through a few hoops and collecting paperwork to file the claim. We’ve covered everything you need to know about getting reimbursed for COVID tests by your insurer.
Where can I get a test?
If you haven’t purchased your test yet, start by checking your insurance company’s website. They may provide a list of in-network pharmacies, retailers, or locations where you can get COVID tests with no out-of-pocket costs. If they haven’t provided a list or you can’t find a location near you, though, don’t despair.
If you purchase an FDA-authorized over-the-counter test out-of-network, private insurers are required to reimburse you for up to $12 per test (or the cost of the test, if less). If a private insurer hasn’t provided a list of in-network purchase options, they are required to cover the full cost of the test, even if it costs more than $12.
Covid-19 test
Easy at-home testing with results in 10 minutes
Covid-19 test
Easy at-home testing with results in 10 minutes
How do I bill my insurance?
If you’ve already purchased tests on or after January 15, make sure you keep your receipt and that your receipt shows the number of tests you’ve purchased. Next, visit your insurance company’s website or call their member services phone number to find out how to submit a claim for reimbursement.
We’ve gathered a list of some popular insurance providers and their guidelines for submitting a claim. If your provider doesn’t appear here, you can visit your insurance company’s website or call their member service department to get details about how to submit your claim.
United Health Care
To submit a claim to United Health Care, sign in to your account. Go to the “Claims & Accounts” tab and select the tab that says “Submit a Claim.” Then, download and print the Medical Claims Submission form. Complete the form and submit it along with the claim details and your purchase receipt by mail to the address listed on your insurance card.
A separate form needs to be submitted for each claim. United Health Care recommends that you keep a copy of the form and the claim details, as well as copies of your receipts. Submit your claim as soon as possible.
☎ Member services phone number: (866) 414-1959
Here’s the website for submitting claims to United Health Care.
Kaiser Permanente
To submit a claim to Kaiser Permanente, download their Member Reimbursement Form here and then submit it by mailing it to the address listed on the form.
Kaiser reminds their members that if you get your test done out-of-network, your test results aren’t automatically shared with your healthcare provider. To share your results, email a scanned copy of your test results to your Kaiser Permanente doctor’s office to keep your medical record up to date. You can submit the information by visiting kp.org.
☎ Member Services phone number: (800) 464-4000
Here’s the claim submission form for Kaiser Permanente.
Anthem
To submit a claim through Anthem, first log in to anthem.com. From there, you can select claims and payment and click on “submit a claim.” You can also find these instructions in Anthem’s COVID-19 resource center here.
Anthem Health also has an app called Sydney Health, which you can use to submit a reimbursement claim. You can download the app from the App Store or Google Play, then follow the Out-of-Network claims submission instructions in the app.
☎ Member services phone number: (855) 817-5785 (TTY: 711)
Follow this link to download the Sydney Health app.
Cigna
Cigna has a specific claim form for reimbursement of out-of-network at-home COVID tests. You can find the form here. Download and print the form and then send it along with your receipt by mail to the address that appears on the back of your insurance ID card, or fax it to 859-410-2422. Make sure you submit a separate claim for every person requesting reimbursement.
☎ Cigna’s customer service phone number: (800) 997-1654
Here is the claim reimbursement form for Cigna.
Medicare
Currently, Original Medicare doesn’t reimburse members for over-the-counter COVID-19 tests purchased independently. They recommend picking up free at-home tests from community health centers and Medicare-certified health clinics.
If you have a Medicare Advantage Plan, you can check to see if your plan will pay for at-home over-the-counter COVID-19 tests, since some plans do offer coverage. The new policy effective January 15 does not apply to Medicare Advantage plans.
☎ Medicare toll-free phone number: (800) 633-4227
Click here for more information about COVID-19 test coverage through Medicare.
Medicaid/CHIP
According to a press release from the White House on January 10th, 2022, “state Medicaid and Children’s Health Insurance Program (CHIP) programs are currently required to cover FDA-authorized at-home COVID-19 tests without cost-sharing.” That means covered individuals can access tests with no out-of-pocket cost if they meet certain conditions (CMS.gov, 2022). Guidelines vary from state to state, so it’s a good idea to contact your provider to determine eligibility conditions and where to get tests. The new policy effective January 15 does not apply to Medicaid-managed care plans.
Rapid COVID-19 tests: available at pharmacies, clinics, and right at home
What if I don’t have insurance?
No insurance? No problem. The White House set up this website where anyone, with or without insurance, can order four at-home COVID tests for every household. Compared to some other options, like in-person retailers or direct-to-consumer websites, shipping is expected to take some time. The government website is still in the early phases, but the website suggests tests should ship out within 7–12 days from the day you order them.
If you need a COVID test more urgently, visit your local government website to find a testing location near you.
References
- CMS. (n.d.). Press Release Biden-Harris Administration requires insurance companies and group health plans to cover the cost of at-home covid-19 tests, increasing access to free tests. Retrieved on Jan. 19, 2022 from https://www.cms.gov/newsroom/press-releases/biden-harris-administration-requires-insurance-companies-and-group-health-plans-cover-cost-home
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.
