AT-HOME COVID-19 TEST COVERAGE

OTC tests will no longer be covered by CMS for members with Part B. Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can still buy them using their quarterly OTC allowance. If you have Original Medicare, Managed Blue for Seniors, or Medex, you'll pay out-of-pocket for OTC COVID-19 tests.

Every U.S. household is eligible to order four free at-home, COVID-19 tests from the Federal Government.

Up to eight FDA-authorized, self-administered, self-read, at-home COVID-19 tests, per member, per month.

Four free at-home, COVID-19 tests from the Federal Government.

A select list (see FAQ below) of tests is covered at no cost when purchased at an in-network pharmacy or ordered through the CVS website at CVS.com.

Any FDA-authorized, at-home COVID-19 test purchased at another retailer outside of our pharmacy network will be reimbursed up to $12 per test.

Most Medicare members will pay out-of-pocket. Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can use their quarterly OTC allowance to buy the tests. However, if you've already met your quarterly allowance, you'll have to pay out-of-pocket for your tests until the start of the next quarter. If you have Original Medicare, Managed Blue for Seniors, or Medex, you'll need to pay out-of-pocket for at-home COVID-19 tests.

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To get tests at no out-of-pocket cost:

1. Visit an in-network pharmacy* and show your member ID card when checking out at the pharmacy counter. *Pharmacies not participating in this program include Kroger, Costco, and a small subset of independent pharmacies.
2. Order through the CVS website at CVS.com or via the CVS Pharmacy mobile app, for pick up or in-home delivery:
   1. From the homepage, click on the Health tab
   2. Click on COVID-19, Learn About At Home Tests
   3. Select Request at-home COVID-19 Tests and follow the prompts with additional questions. You can select pick up or in-home delivery.
   4. You’ll need a CVS.com account to proceed to the next step. Sign in or create one now. CVS.com accounts are different than Caremark accounts. To order OTC tests, you need a CVS.com account.
   5. Have your insurance card on hand and provide the requested information to order your free tests. Include the 9 digit member identification number, do not include the three character prefix.

Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx plans can still purchase OTC tests using their quarterly OTC allowance.

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OTC Shopping page

Visit covidtests.gov

FDA-authorized, at-home COVID-19 tests purchased at out-of network retail locations will be reimbursed at up to $12 per test. To submit:

1. Start your reimbursement online through MyBlue
   1. Sign in to MyBlue
   2. Go to Pharmacy Benefit Manager under My Medications
   3. Look for the At-home COVID-19 test reimbursement banner at the top of the page, click Submit a reimbursement claim
   4. Complete and submit the digital reimbursement form. Note: You will need to upload your receipts.
2. Mail-in form
   1. Complete, print, and mail the CVS Caremark Over-the-counter, at-home COVID-19 Test Reimbursement Claim Form* found here

If you have any questions about ordering online, call CVS from 8:30am-7:00pm EST at 1-800-SHOP-CVS (1-800-746-7287).

If you have any questions about your reimbursement claim submission, call CVS Customer Care 24/7 at 1-877-817-0477 (TTY: 711).

*CVS Caremark is an independent company that has been contracted to administer your pharmacy benefits for Blue Cross Blue Shield of Massachusetts. CVS Caremark is part of the CVS Health family of companies.

Medicare Advantage members with Medicare PPO Blue SaverRx and Medicare HMO Blue SaverRx should follow the steps above to receive tests up front and minimize any out-of-pocket expense. Members with Original Medicare, Managed Blue for Seniors, or Medex will not be reimbursed for tests paid for out-of-pocket.

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