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 eight 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?

When shopping at a pharmacy that has agreed to process the transaction for your over-the-counter (OTC) COVID-19 tests at their pharmacy counter, 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 you did not get your test at the pharmacy counter of a pharmacy, please submit an Rx claim form with your original receipt. Please be sure the receipt includes the following information:

  • Retailer name.
  • Date.
  • Dollar amount of test(s).
  • Quantity of test(s).
  • Name of test.

There is a limit of eight at-home rapid tests per 30 days per member. 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 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.

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.

Are there any options for using my prescription drug coverage to order my OTC COVID-19 tests online at no cost?

Yes. Members with Capital Blue Cross prescription drug coverage can choose to order using one of these two direct-to-consumer shipping options:

Express Scripts® Pharmacy

  • To order, log in to Express Scripts online. If you do not have an account, you can create one using the ID 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 health plan ID 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.

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.