COVID-19 At-home Tests Are Covered by Your Health Plan

COVID-19 At-home Tests Are Covered by Your Health Plan

If you’ve been exposed to someone with COVID-19 or are having symptoms that worry you, taking an at-home COVID-19 test may be a good idea. And the cost of those tests may be covered by your Blue Cross and Blue Shield of Texas (BCBSTX) health plan.

If you are covered by a group or individual and family health plan, you can get reimbursed for your purchase leaving site icon of FDA-authorized, at-home testing kits at $12 per test, or $24 for a box that includes two tests, for up to 8 tests per person every 30 days.

If you have pharmacy benefits through Blue Cross and Blue Shield of Texas/Prime Therapeutics® the tests are covered as a pharmacy benefit. Some pharmacies in the Prime network may submit the claim for you, rather than you having to pay for the tests. Not all pharmacies will file a claim, so you may have to pay for the tests and get paid back. Be sure to keep your receipt – you’ll need it for reimbursement.

Pharmacies in Prime’s network may also be able to deliver or ship at-home test kits. Please check the pharmacy website or app to see if they offer direct shipping mail-order options. There are no up-front costs if you purchase COVID-19 testing kits through a pharmacy that submits your claim online.

If your plan uses some other pharmacy benefit manager, your group health plan administrator can give you information about getting the tests.

How It Works Using Your Benefit Plan Upfront

  1. Go to leaving site icon or to find a pharmacy that has opted into this program.
  2. Buy the at-home COVID-19 testing kits at the pharmacy counter and ask that they submit the claim to us.

If you don’t go to the pharmacy counter and instead use the regular checkout counter, you will have to pay for the test kits. This is also true if you buy them from an approved online retailer. After either one of these, you can file a claim to be paid back for the cost of the tests.

How to Get Reimbursed by Submitting a Receipt

If you have Prime pharmacy benefits but paid out of pocket at your pharmacy, online or at a local retailer:

  • Fill out the Prime reimbursement request form. leaving site icon  
  • Mail the form with the itemized receipt for your purchase attached.
  • Use a separate form for each member.

Call the customer service number on your member ID card if you need help or have any questions about reimbursement.

Learn more about all your COVID-19 testing options.

Revised 2/9/2022, 3/3/2022, 11/29/2022