(WPRI) — Private health insurers are now starting to cover the cost of at-home COVID-19 tests, after a requirement by the Biden-Harris Administration took effect on Saturday.

While the requirement went into effect Saturday, some plans, like Harvard Pilgrim and Tufts, will begin to allow members to print out a form for reimbursement on Jan. 19.

The new coverage requirement means most consumers with private health coverage can go online or to a pharmacy or store, buy a test, and either get it paid for up front by their health plan, or get reimbursed for the cost by submitting a claim to their insurer.

The requirement calls for eight at-home COVID tests being covered per member per month. (Most test kits have two per box, so four boxes would be covered.)

The new federal requirement, however, hinges on tests being available in-stores versus in-stock online, and the process may also be easier depending on if you are purchasing tests at a pharmacy within your insurer’s network.

Additionally, the Biden Administration is allowing Americans to order free at-home rapid tests through the federal government to be delivered through the mail. Beginning on Wednesday, you can request up to four free rapid tests per residential address by going to COVIDTests.gov.

Tests will typically ship within seven to 12 days, and priority given to vulnerable, harder-hit communities.

12 News has compiled information from a few major private health insurers below:

Blue Cross Blue Shield of Massachusetts

As of Jan. 15, Blue Cross Blue Shield will cover up to eight self-administered at-home tests per member per month for personal, diagnostic use, without cost-share and without any need for prior clinical assessment.

The coverage is not retroactive and will not apply to any test kit purchases made prior to Jan. 15.

Blue Cross is creating a national preferred pharmacy network that will initially include over 20,000 retail pharmacies. In the near future, when the network is up and running, Blue Cross members will be able to go to a preferred pharmacy, such as CVS or Walmart, and obtain certain authorized tests for $0.

For members who buy different tests or tests outside this preferred pharmacy network, Blue Cross will reimburse up to $12 per test ($24 for a box of two).

Temporarily, until the network of preferred retail pharmacies is active, Blue Cross will reimburse for the full cost of any FDA-authorized, self-administered test bought at any retailer that typically sells COVID tests.

Additionally, Blue Cross said it will continue to cover FDA-authorized COVID diagnostic tests, such as PCR tests, with no cost share to members when ordered or administered by a health care provider following an individualized clinical assessment. This applies to its commercial and Medicare members.

Blue Cross Blue Shield of Rhode Island

Many Blue Cross Blue Shield of Rhode Island plans include $0 coverage for COVID-19 test kits without a prescription. This coverage applies to all BCBSRI health plans except Medicare starting Jan. 15.

Each person on a BCBSRI non-Medicare plan is covered for up to eight home test kits every 30 days. No prescription or order from a healthcare provider is required.

If you buy the tests at a participating pharmacy (over the counter), you will pay $0 when using your BCBSRI member ID card.

  • Even if a pharmacy is not participating in a BCBSRI network, you may be able to buy the test for $0, so make sure to ask at the pharmacy counter.
  • If you buy the tests at a retail store or online, you’ll need to submit a form, along with your receipt, and will be reimbursed up to $12 per individual test. If a test is sold in a package of two, that is considered two tests, and you will be reimbursed $24.

BCBSRI’s pharmacy network for COVID-19 home test kits includes approximately 65,000 pharmacies nationwide, including CVS and Walgreens. A directory of the participating pharmacies nationwide will be available soon. Find participating pharmacies in Rhode Island »

For those on Medicare, FDA-approved home test kits are covered if you have an order or prescription from a healthcare provider and if the test is medically necessary to diagnose COVID-19. The tests are not covered for screening for COVID-19 in work or public health settings. (BCBSRI will reimburse members for the cost of the test only, and notes shipping, handling, and other fees are not covered.)

The federal government is providing up to 50 million free home test kits to community health centers and Medicare-certified health clinics as well as 500 million home test kits to be distributed for free to Americans who want them.

Harvard Pilgrim Health Care

Per the guidance from the Biden-Harris administration, effective Jan. 15, Harvard Pilgrim will cover the cost of up to eight over-the-counter, FDA-approved, at-home COVID-19 tests per member per month.

Beginning Jan. 19, these members will have the ability to print out a form from our website with instructions on how to submit for reimbursement. In the interim, members are asked to save copies of their receipts for any FDA-approved, at-home COVID-19 tests they purchase on or after Jan. 15.

Harvard Pilgrim said it is working to determine how best to implement this new federal requirement, with a focus on simplifying the process for members.

Although not mandated by the federal requirements, Harvard Pilgrim is also developing a coverage policy for over-the-counter, FDA-approved, at-home COVID-19 tests for Medicare members, and working with state officials in Massachusetts and Rhode Island on covering tests for those enrolled in Medicaid plans.

Tufts Health Plan

Effective Jan. 15, Tufts will cover the cost of up to eight over-the-counter, FDA-approved, at-home COVID-19 tests per member per month (including Tufts Health Direct members).

Beginning Jan. 19, these members will have the ability to print out a form from our website with instructions on how to submit for reimbursement. In the interim, members are asked to save copies of their receipts for any FDA-approved, at-home COVID-19 tests they purchase on or after Jan. 15.

Tufts said it is working to determine how best to implement this new federal requirement, with a focus on simplifying the process for members.

Although not mandated by the federal requirements, Tufts said it is also developing a coverage policy for over-the-counter FDA-approved, at-home COVID-19 tests for Medicare members, and working with state officials in Massachusetts and Rhode Island on covering tests for those enrolled in Medicaid plans.

UnitedHealthcare

Beginning Jan. 15, UnitedHealthcare will cover most individual and employer group health plan members’ FDA-authorized, over-the-counter, at-home COVID-19 diagnostic tests purchased without a doctor’s prescription. This at-home COVID-19 test benefit includes up to eight tests per member every 30 days.

If you are a UnitedHealthcare individual and employer group health plan member with an OptumRx logo displayed on your member ID card, you can now receive reimbursement for an over-the-counter, at-home COVID-19 test.

Members may do this one of two ways:

1.) At an in-store Walmart Pharmacy counter or in-store Rite Aid Pharmacy counter (including Bartell Drugs locations): To get at-home COVID-19 test(s) at no upfront cost, you must make your purchase at an in-store Walmart Pharmacy or in-store Rite Aid Pharmacy counter — and be sure you bring your member ID card with you.

2.) At any other in-store or online retailer: You may submit a receipt for reimbursement online at myuhc.com. You may also submit receipts through a reimbursement form (pdf).

  • Maximum reimbursement of $12 per test
  • Many COVID-19 tests are sold as a 2-pack kit ($12 for each test) and would be reimbursed at a maximum of $24 per kit.

If you do not see an OptumRx logo on your member ID card, you may still submit for reimbursement at myuhc.com or through a reimbursement form (pdf). If you receive insurance through your employer, you may receive more information on this benefit in the future.