COVID-19 Testing at Home

SSHE benefits group (APSCUF, coaches, OPEIU, POA, SPFPA, and management)

The federal government has launched two new initiatives to ensure access to COVID-19 testing at home.

Order Free At-Home COVID-19 Tests -  https://www.covidtests.gov/

Every home in the U.S. is eligible to order four free at-home COVID-19 tests. Order will usually ship in 7-12 days.

Health Plans Required to Cover At-Home COVID-19 Tests

Effective January 15, 2022, group health plans are required to cover the cost of FDA-approved, rapid, over-the-counter (OTC) COVID-19 tests without a prescription during the federally determined public health emergency.

  • The listing of tests covered can be found here.
  • Each Highmark member may be reimbursed up to eight FDA-approved OTC tests per month.

Testing Reimbursement Process

For OTC tests purchased on or after January 15, 2022, Highmark members can complete a claim form and upload a copy of their test receipt (showing the date of purchase) and the universal product code (UPC) found on the test box to the Highmark member portal. Highmark members can also submit a claim by mail. Instructions for both processes are listed below.

Mail-in claim reimbursement process:

  1. Log into the Highmark member portal at the website listed on the back of your member ID card
    1. Or click on the claim form to open and skip to step 4:
  2. Under the “Health Care Tools” section, click on “Find Forms”
  3. Click on the arrow to expand the “Medical Forms” section and click on “PDF” under “Member Submitted Health Insurance Claim Form”
  4. Fill out all necessary/required information on the form
  5. Report “COVID OTC Test Reimbursement” in the “Diagnosis or Nature of Illness or Injury” section of the “Member Submitted Health Insurance Claim Form”
  6. Print the “Member Submitted Health Insurance Claim Form”
  7. Sign and date the “Member Submitted Health Insurance Claim Form”
  8. Mail the “Member Submitted Health Insurance Claim Form” along with a dated receipt of purchase and UPC (Universal Product Code) from the test box to:

Claims
P.O. Box 890173
Camp Hill, PA 17089-0173

NOTE: ** By submitting a manual claim for reimbursement of and OTC COVID-19 test, the member is attesting that the test was purchased for personal use, not for employment purposes, and will not be reimbursed by another source or used for resale **

Digital member portal claim reimbursement process:

  1. Log into the Highmark member portal at the website listed on the back of your member ID card
  2. Under the “Health Care Tools” section, click on “Find Forms”
  3. Click on the arrow to expand the “Medical Forms” section and click on “PDF” under “Member Submitted Health Insurance Claim Form”
  4. Fill out all necessary/required information on the form
  5. Report “COVID OTC Test Reimbursement” in the “Diagnosis or Nature of Illness or Injury” section of the “Member Submitted Health Insurance Claim Form”
  6. Save the “Member Submitted Health Insurance Claim Form” to your computer
  7. Print the “Member Submitted Health Insurance Claim Form”
  8. Sign and date the “Member Submitted Health Insurance Claim Form”
  9. Upload the “Member Submitted Health Insurance Claim Form” along with an image of the dated receipt of purchase and UPC (Universal Product Code) label from the test box, via Message Center on the Member Portal under “Your Account”.
  10. Click on “Contact Us”
  11. Select your medical plan
  12. Select Message Topic of “Claim Inquiry”
  13. Indicate the inquiry is for “COVID OTC Test Reimbursement”
  14. Click on the Paperclip icon next to “Attach File” and browse to where you saved the “Member Submitted Health Insurance Claim Form” and copies of the receipt and UPC (Universal Product Code) label on your computer
  15. Complete any of the other required fields
  16. Click the “Submit” button

NOTE:  ** Please submit a separate claim form for each patient.  All expenses for one patient can be submitted with one claim form.**

For more information, please refer to Highmark’s FAQs - https://faqs.discoverhighmark.com/over-the-counter-test-reimbursement/