Over-the-counter COVID-19 tests
Frequently asked questions
The federal government required health plans to cover up to eight at-home, OTC COVID-19 tests per member every 30 days through the end of the COVID-19 public health emergency (PHE). The PHE ended on May 11, 2023.
For OTC tests purchased on or after May 12, 2023, Capital Blue Cross will no longer cover the cost of these tests through medical or pharmacy benefits. This applies to most self-funded (or self-insured) employer-sponsored health and welfare plans, insured group plans and individual/family plans. If you are covered through an employer, you can also ask your Human Resources Department if the coverage is self-funded or an insured group plan.
Note for members with Children's Health Insurance Program (CHIP) coverage through Capital Blue Cross: We will continue to cover eight at-home tests every 30 days for CHIP members through September 30, 2024.
Important update: Effective September 25, 2023, the federal government is again making free OTC COVID-19 tests available. Every U.S. household can place an order to receive four free COVID-19 tests delivered directly to their home.
Here are answers to CHIP member questions about health plan OTC test coverage:
How can I use my plan’s prescription drug coverage to order free OTC, at-home COVID-19 tests online?
Members with Children's Health Insurance Program (CHIP) coverage through Capital Blue Cross can use two options:
Express Scripts® Pharmacy
- Log in to Express Scripts online. If you do not have an account, you can create one using the information on your ID card.
- Express Scripts offers an “Order At-Home COVID Tests” option.
Thrifty White Pharmacy
- Visit Thrifty White's Online Drugstore to set up an account by providing your date of birth and plan number on your ID card.
- Place your order for FlowFlex COVID-19 tests. Enter PT22Flow as your coupon code to ensure your COVID-19 test order is processed at no charge.
- If you have questions or need assistance, call Member Services using the number on the back on your ID card.
How do I use my insurance plan to cover OTC, at-home COVID-19 tests I buy in person at a pharmacy or through a retailer?
Be sure to check out at the pharmacy counter and present your prescription drug ID card. When you do, the pharmacist will process your tests with no copay, and you won't have to save your receipt or submit a claim form.
If you purchased your tests online, from a nonpharmacy retailer, or you did not buy your test at the pharmacy counter within the pharmacy, submit an Rx claim form with your original receipt. Note that, except for CHIP plans, we will not cover the cost of OTC COVID-19 tests purchased on or after May 12, 2023. Be sure the receipt includes the retailer name, date, dollar amount of test(s), quantity of test(s), and name of test. Reimbursement may be limited to no more than $12 per test.
If you do not have prescription drug coverage through Capital Blue Cross, please check with your employer or benefits manager to learn about your reimbursement options for OTC COVID-19 tests.
Please note that we are not able to reimburse for test kits purchased from individuals or from resellers such as eBay, Craigslist, and Facebook Marketplace.
My employer requires COVID-19 testing as a condition of my employment. Is reimbursement available for OTC, at-home COVID-19 tests for employment purposes?
No. We do not provide coverage of COVID-19 testing, including OTC tests, for employment purposes.
The expiration date on the test’s packaging says it has expired or will expire soon. How can I find out if the shelf life has been extended?
The shelf life of some OTC tests has been extended. The U.S. Food & Drug Administration (FDA) offers information on OTC COVID-19 tests authorized for at-home use. Visit the FDA’s OTC COVID-19 test webpage for details about whether a test’s shelf life has been extended.