14
January
2022
|
18:35 PM
America/New_York

Free At-Home COVID-19 Tests: Your options

Summary

Federal website provides free tests delivered to your mailbox; Horizon provides coverage for tests to eligible members

The Federal government is providing every household with 4 free at-home COVID-19 tests.  Get yours by providing your name and mailing address on the US Post Office’s COVID-19 test ordering site .

All New Jerseyans are also eligible for free test kits from the State. Find out more by visiting the New Jersey COVID-19 Information Hub.

In addition, effective January 15, 2022, eligible Horizon members are covered for up to eight at-home, FDA-approved over-the-counter (OTC) COVID-19 tests every 30 days for diagnostic purposes. This means you are taking a test because you have COVID-19 symptoms or because you were exposed to someone who has COVID-19. Claims for diagnostic testing are covered by your insurance with no out-of-pocket costs. A doctor’s order is not required.

The Horizon benefit does not apply if you are testing to go to work or school, for travel or for a reason not related to illness (called “surveillance tests.”)  Surveillance tests are not covered by insurance. The Federal government free tests are not limited to diagnostic purposes.

Who is eligible?

Every home in the U.S. is eligible for the free test from the Federal government.

For the Horizon program, members enrolled in Commercial market health plans have this new coverage beginning January 15, 2022. The coverage requirement applies to members enrolled in fully insured and self-insured health plans.

Horizon will administer the coverage for self-insured accounts that have prescription drug benefits with us through our pharmacy benefits manager (PBM), Prime Therapeutics LLC.

We are working with the State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) on their administration of this coverage requirement. All other self-insured accounts that have carved out their pharmacy benefit to a different PBM will need to work with their PBM to administer these benefits to their members.

This coverage requirement also applies to members enrolled through the Federal Employee Program (FEP), and we will work with the FEP to administer this coverage requirement to their members.

This benefit does not apply to you if:

  • You get your coverage through Medicaid (Horizon NJ Health). Medicaid plans already cover at-home COVID-19 testing at no cost. The State of New Jersey will soon implement a new coverage requirement for Medicaid plans to cover OTC, at-home COVID-19 testing. More information will be provided as soon as it is available.  Until then, the State is offering free at-home tests through its website.
  • You are a Medicare Advantage member. However, you are covered for COVID-19 testing when ordered by a doctor. Medicare Advantage members also have access to free at-home tests at community health centers and Medicare-certified health clinics. Up to 50 million of these tests are provided by the U.S. Department of Health & Human Services at no cost. You can learn more about this program here.

How to receive your tests through Horizon’s benefit program

From a pharmacy

  • You can obtain up to eight tests from the pharmacy (note that tests often come in packages of two tests, so four packages) for your personal use for no out-of-pocket costs.
  • Every eligible member, including your spouse and dependents enrolled through your plan, may obtain up to eight tests every 30 days.
  • If you obtain your tests from an in-network pharmacy, you do not need to submit claims and there is no cost to you.

From any other source

  •  If you purchase an FDA-approved, OTC test to diagnose a COVID-19 infection from another source, you must submit a claim for reimbursement to Prime Therapeutics LLC. The pharmacy claim form is available on HorizonBlue.com. You will be reimbursed for the cost of the test or $12 per test, whichever amount is lower.

Regardless of how you get your tests through Horizon, pharmacies and online retailers may limit the number of tests you can buy at one time due to supply issues.

Remember, any test purchased for surveillance purposes (for example, testing required to go to work or school, for travel or for some other reason not related to illness) is not covered by insurance.

For questions or more information, please visit HorizonBlue.com/covid19

Vaccinations are still your best defense

Vaccination is the most effective action we can take to protect ourselves, our families and our communities. As a reminder, the COVID 19 vaccines are available at no cost to you.