Over-the-counter COVID-19 tests

Frequently asked questions

One way to get tests is through a federal program offering free at-home COVID-19 tests. Every household in the U.S. is eligible to receive four free at-home COVID-19 tests. Order your free tests.

In addition, effective January 15, 2022, we cover certain FDA-approved over-the counter (OTC) COVID-19 diagnostic tests--up to eight OTC at-home tests per covered individual per 30-day period. Please note that most tests are packaged with multiple tests per package. This coverage is per test, not per package.

We will continue to cover the cost of OTC tests through the end of the national Public Health Emergency (PHE).

Here are answers to member questions about this temporary coverage change.

The Biden Administration announced that it is offering at-home tests for free through a federal website. How can I order free COVID-19 tests for my household?

Every U.S. household can order up to four free at-home COVID-19 tests.

How many OTC COVID-19 tests will be covered through my health plan?

Your plan will cover up to eight free over-the-counter (OTC) at-home tests per covered individual per 30-day period. Please note that most tests are packaged with multiple tests per package. The coverage is per test, not per package.

How do I get OTC COVID-19 tests covered through my health plan?

There are two ways to get your OTC COVID-19 tests covered through your health plan.

  1. When shopping at a pharmacy, 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 at a $0 copay, and you won’t have to save your receipt or submit a claim form.

    If you purchased your tests online or not through the pharmacy counter of an in-network pharmacy, you can submit an Rx claim form with your original receipt.

  2. If you do not have pharmacy coverage through Capital Blue Cross or purchased your tests through a retailer who is not in our pharmacy network, or doesn’t even have a pharmacy, you will need to save your receipt and submit a claim form for reimbursement.

    Please note you only need to fill out sections 1, 2, and 7 of the claim form and include your original receipt.

If you are submitting a paper claim, please be sure the receipt includes the following information:
  • Retailer name.
  • Date.
  • Dollar amount of test(s).
  • Quantity of test(s).
  • Name of test.

My pharmacy asked me to pay for the OTC COVID-19 tests and submit a claim for reimbursement. Why couldn’t I get the test at no charge?

We do have a solution in place for members to check out at the pharmacy counter and present their prescription drug ID cards. This allows members get OTC COVID-19 tests at a $0 copay.

However, we have heard that some pharmacies are asking people to pay for the OTC COVID-19 tests up front and submit a claim to their health insurer, along with a copy of the receipt, in order to request reimbursement.

Health plan coverage of OTC COVID-19 tests began nationwide on January 15, 2022. Pharmacies are working to ensure that their systems are able to process these purchases. However, there may be cases where a pharmacy cannot support the use of prescription drug ID cards for people to get the tests at a $0 copay.

If you were unable to get your test using your ID card, you can submit a prescription drug claim form, along with a copy of your receipt, to request reimbursement.

Where can I find OTC COVID-19 tests covered through our network?

We will cover up to eight OTC COVID-19 tests that are FDA approved with emergency use authorization (EUA). These tests are sold at an ever-growing list of retailers, though they may be hard to find due to a limited supply and high demand.

Will retail pharmacies be able to ship COVID tests?

Yes, OTC COVID-19 tests can be shipped to members from retail pharmacies, other retailers, and online retailers.

I bought OTC tests prior to January 15, 2022. Can I request reimbursement for those tests?

No. Reimbursement for OTC COVID-19 tests purchased prior to January 15, 2022 is not available.

Are OTC COVID-19 tests covered even if the tests were not ordered or recommended by my healthcare provider?

Yes. OTC COVID-19 tests purchased without an order or individualized clinical assessment by a healthcare provider are covered—up to eight tests per covered individual per 30-day period. Please note that most tests are packaged with multiple tests per package. The coverage is per test, not per package.

Do I need to request preapproval from you in order to get coverage for my OTC COVID-19 test purchase?

No. Preapproval is not required.

My employer requires COVID-19 testing as a condition of my employment. Can I be reimbursed for OTC COVID-19 tests for employment purposes?

No. We do not provide coverage of COVID-19 testing, including OTC tests, for employment purposes.

Do you still cover the cost of COVID-19 tests administered with a healthcare provider’s involvement or prescription?

Yes. During the national Public Health Emergency (PHE), we will cover the cost of a COVID-19 diagnostic test without applying member cost share (such as deductibles, copays, and coinsurance) for tests ordered by a provider or when a provider refers you for a test.