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At-home COVID-19 tests

Your benefits may cover at-home COVID-19 tests. To learn what your plan covers and how to get your tests, log in to your Aetna® member website.

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At-home COVID-19 tests are now covered under many plans

 

Here’s what you need to know

Have individual, student health or employer group insurance? Thanks to new federal guidelines, you and everyone covered under your plan are eligible for eight at-home COVID-19 tests per 30-day period during the public health emergency. These are also known as over-the-counter (OTC) tests. Just keep in mind that you need to have bought them on or after January 15, 2022, to be covered.

 

As of April 4, 2022, members with Medicare Part B can get up to eight over-the-counter COVID-19 tests each month while the COVID-19 public health emergency lasts. This includes those enrolled in a Medicare Advantage plan. The tests come at no extra cost. Members must get them from participating pharmacies and health care providers. They should check to see which ones are participating. Providers will bill Medicare.

 

Note: This coverage isn’t available under our supplemental accident, critical illness and hospital indemnity plans. If you’re a Medicaid member, check your plan to see if at-home COVID-19 tests are covered in your state.

 

If you have individual, student health or employer group health insurance, you can get at-home COVID-19 tests covered by your benefits.

 

As of April 4, 2022, members with Medicare Part B can get up to eight over-the-counter COVID-19 tests each month while the COVID-19 public health emergency lasts. This includes those enrolled in a Medicare Advantage plan. The tests come at no extra cost. Members must get them from participating pharmacies and health care providers. They should check to see which ones are participating. Providers will bill Medicare.

 

Note: This coverage isn’t available under our supplemental accident, critical illness and hospital indemnity plans. If you’re a Medicaid member, check your plan to see if at-home COVID-19 tests are covered in your state.

We’ll cover up to eight COVID-19 diagnostic antigen rapid home tests per 30-day period for each person covered under your plan. For example, a family of four covered under the same plan will be reimbursed for up to 32 tests per 30-day period. 

 

Things to remember:

 

  • Aetna will cover up to eight 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, BinaxNOW™ offers a package with two tests included. That would count as two individual tests).
  • 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. 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 unless required by state law.

Aetna® Medicare plans do not reimburse for OTC COVID-19 tests. Aetna Medicare members can get OTC COVID-19 tests from participating providers and pharmacies. But they won’t be reimbursed for self-purchased tests. You can find a partial list of participating pharmacies at Medicare.gov. Members should take their red, white and blue Medicare card when they pick up tests. They can also order up to two sets of four at-home tests per household by visiting COVIDtests.gov.

 

Looking for more information about testing? Check out our broader testing coverage frequently asked questions.

Members who have Aetna pharmacy benefits can submit a claim for reimbursement through their Aetna member website. Simply log in at Aetna.com and choose “Learn About Test Kits & Reimbursement.”.

 

If your pharmacy benefits are not with Aetna, contact your pharmacy benefits administrator for instructions.

 

Medicare will reimburse one self-ordered, at-home lab-processed kit each year. They will reimburse for other at-home, lab-processed kits that are prescribed by a provider. Kits other than those that are processed at home aren’t subject to reimbursement. Members can get OTC kits only from participating providers and pharmacies. You can find a partial list of participating pharmacies at Medicare.gov. Members should take their red, white and blue Medicare card when they pick up tests. They may also order up to two sets of four at-home tests per household by visiting COVIDtests.gov.

You can buy at-home COVID-19 tests at pharmacies, retail locations or online. Remember to keep your receipts.

 
 

The information contained in this FAQ is subject to change at the discretion of CVS at any time, for any reason and without advanced notice.

Aetna will follow all federal and state mandates for insured plans, as required. All trademarks and logos are the intellectual property of their respective owners.

Disclaimer: Regulations regarding testing for Aetna Medicaid members vary by state and, in some cases, may change in light of the current situation. Providers are encouraged to call their provider services representative for additional information.

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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.

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