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Over-the-counter (OTC) COVID-19 at-home test reimbursement FAQ

How can I get a free at-home COVID-19 test?

As a Moda Health member, you can now get free OTC COVID-19 at-home test. Here’s how:

All Moda members

  • Order through the federal government: Visit COVIDtests.gov to order a set of 4 free COVID-19 tests. Every household in the U.S. can get the tests.

Members with individual and family, or employer group coverage

  • Pick up at your in-network pharmacy: When picking up a test at your pharmacy, show your Moda member ID card to get a free test.
  • We will reimburse you: Buy a test at any pharmacy, or in-person or online retailer, then use our claim form to get reimbursed. We will reimburse up to 8 tests per member ($12 per test) over a 30-day period. This includes tests purchased on or after Jan. 15, 2022.
    • Tests purchased in-person at a pharmacy: Use this claim form if you purchased your tests at a pharmacy and had to pay out of pocket for the tests.
    • Tests purchased from an online pharmacy: Use this claim form if you purchased your tests from an online pharmacy.
    • Tests purchased from a retailer on online retailer: Use this claim form if you purchased your tests from a retailer other than a pharmacy. Be sure to include a copy of your itemized receipt.

Are there limits to the reimbursement amount?

Yes. Following federal regulations, Moda Health will reimburse you up to $12 per test for tests purchased on or after Jan. 15, 2022 until the end of the federal public health emergency. We will reimburse up to 8 tests per 30 days for each person on a Moda Health plan, no matter if the tests are bought all at once or at separate times during the 30-day period. Moda will cover up to eight tests if they are bought individually or in a pack that includes multiple tests. We do not cover tests that were purchased before to Jan. 15, 2022.

Please note that shipping costs do not apply to reimbursement.

Where can I find a COVID-19 at-home test?

COVID-19 at-home test may be available at a variety of retailers, such as pharmacies, large grocery chains and online retailers. Right now, these tests are in high demand. It may be a good idea to call before you visit the store in-person to see if they have any in stock. To find in-network pharmacies, use our Moda Pharmacy Search.

When should I take an at-home test?

You may choose to take an at-home test if you have symptoms of COVID-19 or have been exposed to someone with COVID-19. An at-home test may confirm if you have COVID-19.

If your employer requires you to get tested, please note that Moda Health does not cover testing for employment purposes.

Why can't Medicare members get reimbursed for purchasing at-home tests?

Currently, Medicare pays for COVID-19 tests performed by a lab, such as PCR and antigen test, if the test is ordered by an authorized healthcare professional. Moda Health will continue to follow federal reimbursement guidance.

I think I may have COVID-19 but I can't find an at-home test? What can I do?

Right now, these tests are in high demand. That, combined with supply chain issues nationwide, may make finding these tests a challenge. As the system works through these issues, testing sites and testing clinics are another option. However, you will want to be aware of the costs. Some locations offer free tests and others may charge you. The cost varies by location and may or may not be covered by Moda. Also, please make sure to confirm it is a valid testing site. Go to your state health website to find a testing location near you.

What will I receive at the time of reimbursement?

You will receive a check in the mail, along with an explanation of payment.

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