1/18/2022
Effective Jan. 15, 2022, Marshall Health employees with the Highmark Blue Cross Blue Shield of WV employer-sponsored health insurance coverage can seek reimbursement for the purchase of over-the-counter COVID-19 tests from their employer group or health insurer.
Read the FAQs below or download the Highmark flyer to learn more.
The Biden administration announced new federal guidance on Jan. 10, 2022, that people with employer-sponsored or individual health insurance coverage can seek reimbursement for the purchase of over-the-counter COVID-19 tests from their employer group or health insurer, effective Jan. 15.
Over-the-counter, at-home, diagnostic tests that are approved by the FDA (list of approved tests maybe found here) can qualify for reimbursement. Per federal guidelines, Highmark members can seek reimbursement for up to 8 qualifying tests per month per member. That means a family of four can be reimbursed for 32 tests per month.
Note: Tests may be packaged individually or with multiple tests in one package (for example, two tests packaged in one box). Plans are required to cover 8 tests per covered individual per month, regardless of how they are packaged and distributed.
Highmark members with employer-sponsored or individual health insurance coverage can seek reimbursement for the purchase of over-the-counter COVID-19 tests.
Highmark Medicare Advantage members are not eligible for reimbursement at this time. The Biden administration did not include Medicare in this guidance and Medicare will not pay for at-home tests through this program. Highmark’s Medicare Advantage members, however, can continue to have access to COVID-19 testing at no cost when ordered by a clinician.
You will need to submit the following documentation, following the instructions below, to receive reimbursement for your over-the-counter test:
Mail-in claim reimbursement process:
Digital member portal claim reimbursement process:
NOTE: ** By submitting a manual claim for reimbursement of an over-the-counter COVID-19 test, the member is attesting that it was purchased for personal use, not for employment purposes, and will not be reimbursed by another source or used for resale **
Michele McKnight
Marshall Health & School of Medicine
Assistant Director of External Affairs
304-691-1713
mcknigh4@marshall.edu
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