At-Home COVID-19 Self-Test Coverage & FAQs for Members

Reimbursement for over-the-counter (OTC) COVID-19 at-home test kits

New federal guidelines allow members with private or employer-sponsored commercial health insurance to request reimbursement for over-the-counter COVID-19 diagnostic tests that are purchased on or after January 15, 2022. This mandate is in effect until the end of the federal public health emergency.

Be sure to check back regularly as information is evolving quickly.

What you need to know

If you have private or employer-sponsor health insurance you’re eligible to get reimbursed for over-the-counter at-home COVID kits.

Note: This new coverage reimbursement policy doesn't apply to members who have Medicare, Medicare Supplement, Medicaid or voluntary insurance.

Based on the guidelines provided by the Biden administration, we will cover up to eight (8) over the counter (OTC) at-home COVID-19 tests per 30-day period for each person covered under your plan.

Note: Each test is counted separately even if multiple tests are sold in a single package. For example, a family of four covered under the same plan could be reimbursed for up to 32 tests per 30-day period.

Other things to keep in mind:

Tests must be approved, cleared or authorized by the U.S. Food and Drug Administration.
You can only get reimbursed for tests purchased on January 15, 2022 or later.
These tests don’t require an order from your physician to qualify for reimbursement, although tests ordered by a provider aren’t subject to the frequency limit.
Tests must be used to diagnose a potential COVID-19 infection. Tests used for employment, school or recreational purposes are not eligible for reimbursement.
You can browse Aetna’s broader testing coverage frequently asked questions.

In most cases, OTC tests will be covered under your pharmacy benefits. Just check your benefits card to find your prescription benefits manager.

At this time, you’ll need to submit a request for reimbursement.

For Aetna medical members with prescription coverage:

We’ll be sharing information about how to submit claims for over the counter at-home COVID-19 tests soon for tests purchased on or after January 15, 2022.

For members with third-party Rx/pharmacy vendors

You can find contact information on your Pharmacy Benefit Manager card.

You can buy OTC COVID-19 tests at pharmacies, retail locations or online. Just keep in mind that the Omicron variant has created an overwhelming demand for OTC COVID-19 tests in many communities, so supplies may be limited.

To help improve access to these tests, the Biden-Harris Administration is expanding access to free, at-home kits through the federal government. More information on this program is expected soon.

COVID-19 member resources page

Federal Administration Over-the-Counter COVID-19 HHS News

CDC COVID-19 testing: What you need to know

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.