NRECA Employee Benefits Weekly

Summary of Over the Counter COVID Test Coverage

Posted on Posted in Group Benefits

As of January 15, 2022, the NRECA Medical Plan is covering at-home over the counter (OTC) COVID-19 tests approved by the Food & Drug Administration.

Participants purchasing at-home over the counter FDA-approved COVID-19 tests will be reimbursed up to $12 per test for a total of eight tests per month, per participant. Additionally, test kits containing multiple tests will have the necessary reimbursement parameters applied (e.g., a kit containing two tests can be reimbursed up to $24 and will have two tests counted toward the eight test monthly maximum). Polymerase Chain Reaction (referred to as PCR) home collection kits that are sent to a lab are not eligible for reimbursement at this time.

Direct coverage

  • Participants can receive FDA-approved at-home over the counter COVID-19 tests at most pharmacies within the CVS Caremark National Network that bill directly to their pharmacy benefit, with no out-of-pocket cost. Note: Some pharmacies may not be able to process claims for at-home over the counter COVID-19 tests at this time.
  • If the pharmacy can’t bill directly to the pharmacy benefit, or if the participant buys a test at a non-participating pharmacy or online, they will have to pay for the test and request reimbursement.
  • We advise participants contact their local pharmacy to check test availability and if the pharmacy is providing direct coverage or if the participant will need to seek reimbursement.

Reimbursement process

  • Reimbursement for FDA-approved at-home over the counter COVID-19 tests purchased at pharmacies or other retail locations can be requested through caremark.com under the Plan & Benefits tab and selecting “Submit Prescription Claim.” Participants can access the site directly through cooperative.com > My Benefits > My Insurance > Prescription Drug.
  • Participants will need to upload a digital receipt or photo of the receipt. Participants will be reimbursed $12 per test or the amount paid out-of-pocket, whichever is lower.
  • Participants can access a form to complete and mail to CVS with the required documentation from the Employee Benefits website’s participant landing page in the “announcements” module. This form is also available on the COVID-19 Resources page for benefits administrators.

The government has purchased FDA-approved COVID-19 at-home tests that can be requested (without charge) by visiting covidtests.gov. Participants may wish to use this option if they are having difficulty locating tests in their community.

Questions
This information has been added to the benefits administrator and participant COVID-19 resources pages on the NRECA Employee Benefits website, including a link to a document containing answers to frequently asked questions developed by CVS. As this process continues to evolve, we will be providing additional information.

Participants with specific questions should reach out to the Member Contact Center, option 1 or CVS Customer Care at 888.796.7322.

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