COVID-19 Coverage Expanded to Include Over-the-Counter Test Kits

A recent announcement from the federal government intends to increase access to COVID-19 testing. As of January 15, 2022, you can get reimbursed by your health plan for the costs of over-the-counter diagnostic COVID-19 tests until the end of the Coronavirus Public Health Emergency. Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed.

Who should take a test and when?

The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. Visit the CDC website for the most up-to-date testing guidance.

Where can I find a test?

• Visit COVIDtests.gov for information on free tests that may be available through government services.
• Anthem has a limited number of at-home diagnostic test kits available for certain members to order online. Log in using the Sydney^SM Health mobile app or at anthem.com/ca. If you’re eligible to order an at-home test, you’ll see the option to place an order. If you don’t see that option, you’re ineligible but you still have other testing options available.
• You can still use in-person diagnostic COVID-19 testing sites. These may include your doctor’s office, a pharmacy or health clinic, or an urgent care center. Use our COVID-19 Test Site Finder to find a testing location close to you.
• At-home diagnostic tests can be purchased over the counter, online, at a local pharmacy, or from a big-box store.

How does my plan cover the over-the-counter test?

From January 15, 2022 until the end of the Coronavirus Public Health Emergency, each individual on your plan can get up to eight over-the-counter tests each month. If you purchase a test kit that includes two rapid tests, that will count as two of your eight covered tests. The federal requirement covers your cost for diagnostic tests. However, in compliance with California state law, some Anthem plans also cover COVID-19 screening tests with no out-of-pocket costs. If you're not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card.

How do I get reimbursed?

You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Log in to anthem.com/ca, go to Claims & Payment, and choose Submit a Claim. You can also log in to the Sydney^SM Health mobile app, go to Claims, and choose Submit a Claim. If your employer has asked you to submit receipts to your pharmacy benefit plan, please don’t submit them here.

If you have an Anthem Medicaid or Medicare plan, you will need to visit your member website for information on how your health plan covers COVID-19 testing.

Can I visit the emergency room for a test?

As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. Only visit the ER or call 911 if you're experiencing life-threatening symptoms.

_{Sources:
Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov.
Centers for Disease Control and Prevention website: Testing Strategies for SARS-CoV-2 (accessed January 2022): cdc.gov.}