It was recently announced that medical plans would provide coverage for up to eight (8) COVID-19 tests per month, per covered individual.
Only FDA-authorized over-the-counter (OTC) COVID-19 at-home test kits will be covered under the mandate.
To clarify, the eight (8) tests per month only applies to tests administered without a health care provider’s involvement or prescription.
How does it work?
Here are the options:
Point of Sale (POS)
Elixir, our pharmacy manager, will allow you to purchase a test at the counter at no cost to you. This POS submission is available at the pharmacy counter for test kits from in-network, participating pharmacies.
- Tests MUST be purchased at the pharmacy counter.
- The member MUST present their ID card at time of purchase.
- Otherwise, the reimbursement process would be followed.
Note: Elixir indicated that while they are ready to process these POS claims, some network retail pharmacies may not yet be ready to process without a prescription.
If you are told a prescription is required for the claim to process through the pharmacy, you may ask your health care provider to call one in, or you may purchase the kit outside the pharmacy and file a reimbursement form with Med-Pay (as described below).
Direct Member Reimbursement (DMR)
For tests purchased through non-participating pharmacies, retailers, online, or participating pharmacies as noted above, you will be required to pay the upfront cost of the tests.
Then you must submit a reimbursement form to Med-Pay to receive reimbursement.
This reimbursement can be filed directly with Med-Pay by submitting the claim form, with accompanying receipt and UPC Code information.
Note: This form will also be available shortly on Med-Pay’s website:
- Visit the “Resources” tab.
- Select “PDF Forms.”
- Choose “For Employees” from the drop down option.
For assistance completing the form, contact Med-Pay Customer Service directly at 417-886-6886 or toll free at 800-777-9087.
Finally, as a reminder, the federal government made four antigen test kits available to every household via covidtests.gov, and we encourage you to take advantage of this option as well.