Starting January 15, 2022, you have $0 coverage for COVID-19 home test kits without a prescription, and each person on your plan is covered for up to 8 individual home test kits every 30 days. Please note that these home test kits can’t be used for workplace screening or travel. 

If you buy the tests at a participating pharmacy—at the pharmacy counter—you will pay $0 when using your BCBSRI member ID card. (CVS, a participating pharmacy, has a different process for getting your home test kits for $0. See the FAQ below for details.) However, even if a pharmacy is not participating in our network, you may be able to buy the test for $0. Please ask at the pharmacy counter.

Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. This network may be different than your plan’s standard pharmacy network. You can view a complete list of participating pharmacies in Rhode Island or search the national directory for participating pharmacies. You don’t need to sign in to search for a pharmacy. After choosing “BCBS Rhode Island” as your health plan, select the “Rhode Island Pharmacy Network” (which is a national network) and enter your ZIP code. 

If you buy the tests online or at a retail store (including the regular store checkout at a pharmacy rather than the pharmacy counter), you’ll need to submit a form, along with your receipt, and will be reimbursed up to $12 per individual test. If a test is sold in a package of two, that is considered two tests and you will be reimbursed $24. Please note that taxes and other fees are not covered. To get reimbursed, please download this form and mail it to the address listed, along with a receipt. Your signature is also required in the “COVID-19 home test kit claim” section. 

As of April 4, 2022, members with BCBSRI Medicare Advantage and Plan 65 coverage can now receive COVID-19 home test kits at no cost under their Part B benefit. You can get up to 8 individual tests per calendar month from participating pharmacies and healthcare providers during the COVID-19 public health emergency. See the list of participating pharmacies and healthcare providers. 

At a participating pharmacy, go to the pharmacy counter (not the store checkout) and use your red, white, and blue Medicare card. The $0 coverage only applies when received at participating pharmacies or through participating healthcare providers. This coverage can’t be used for workplace screening or travel. Please note that you can’t submit for reimbursement for a home test kit unless you have a doctor’s note or prescription. 

If you have a BCBSRI Medicare Advantage plan that includes a quarterly OTC allowance ($25-$275, depending on your plan), you can also use it to buy COVID-19 home test kits. However, we recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed. To use your quarterly OTC benefit, you must buy the home test kits in store through the national retailers in your OTC network: Walmart, Dollar General, Family Dollar, Rite Aid, Walgreens, and CVS Pharmacy^®. 

If you are asked to pay for the tests at the regular store checkout, you can let the pharmacy know your coverage is through Prime. Prime has an established electronic connection with most pharmacies, even those not in their network, and the claim should process successfully. If the pharmacy continues to direct you to pay at the regular store checkout, please consider paying for the test kit and submitting for reimbursement or trying to use a different pharmacy. Please note that this does not apply to members with BCBSRI Medicare Advantage or Plan 65 coverage.

For members of BCBSRI Medicare Advantage and Plan 65 
You can only use your $0 coverage at pharmacies and healthcare providers participating with this specific program. See the list.

For members of all other BCBSRI heath plans
Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. Please note that this network may be different than your plan’s standard pharmacy network. You can view a complete list of participating pharmacies in Rhode Island or search the national directory for participating pharmacies. You don’t need to sign in to search for a pharmacy. After choosing “BCBS Rhode Island” as your health plan, select the “Rhode Island Pharmacy Network” (which is a national network) and enter your ZIP code. 

There are different ways to submit your reimbursement depending on your plan. Please note that taxes and other fees are not eligible for reimbursement.

• For members of BCBSRI Medicare Advantage and Plan 65 
  You aren’t able to submit for reimbursement for home test kits purchased without a prescription or provider’s order. If you do have a provider’s order or prescription, you can submit a claim for reimbursement electronically by logging in to myBCBSRI.com.
• For members of all other BCBSRI health plans 
  You can download this form and mail it to the address listed, along with a receipt. Your signature is also required in the “COVID-19 home test kit claim” section. You'll be reimbursed by check within 60 calendar days.

For members of BCBSRI Medicare Advantage and Plan 65 
FDA-approved tests are covered for $0 when received at a pharmacy or healthcare provider participating with the federal government. See the list.

For members of all BCBSRI plans except Medicare
All FDA-approved home test kits are covered without a prescription. The tests listed below are available for $0 at the pharmacy counter. For other FDA-approved home test kits (that are generally not available at pharmacies), you can submit a claim for reimbursement.

This list is subject to change as additional home test kits become available.

The process for getting COVID-19 home test kits for $0 at CVS is different than other participating pharmacies. Instead of showing your BCBSRI member ID card at the pharmacy counter, you provide that information online and then pick up the home test kits at a CVS Pharmacy location. Here is the process:

1. Visit CVS.com^® or the CVS Pharmacy app and click on “At-home COVID-19 tests.”
2. Click on “Request at-home tests,” and enter your ZIP code for details on the closest store and product availability.
3. Provide your BCBSRI health plan information and follow the steps to order the tests. (If you don’t already have a CVS account, you’ll need to create one.)
4. Once you receive a confirmation from CVS Pharmacy, your order will be waiting for you at the front store register. Please note that orders will be held for 72 hours and cannot be picked up at the drive-through.

If you prefer to have your home test kits shipped to your house, you can pay out-of-pocket and submit for reimbursement using this form. Please note that this does not apply to members with BCBSRI Medicare Advantage or Plan 65 coverage.

No, you don’t need an order or prescription unless you are buying more test kits than allowed under your $0 coverage or at a location that is not participating with your Medicare Part B benefit. 

Home test kits are tests you can do at home and read yourself, without the help of a provider or lab. The CDC states that home test kits may be used in the following situations:

• You have COVID-19 symptoms.
• You have been exposed or potentially exposed to an individual with COVID-19 (even if you don’t have symptoms).
• Even if you don’t have symptoms and have not been exposed to someone with COVID-19, using a home test kit before gathering indoors with others can give you information about the risk of spreading the virus that causes COVID-19. This is especially important before gathering with unvaccinated children, older individuals, those who are immunocompromised, or individuals at risk of severe disease.

On the CDC website, you can find additional information, including how to use home tests and what to do if your test is negative or positive.
 

An FDA-approved home test kit would be eligible for reimbursement if you had an order or prescription from a healthcare provider and if the test was medically necessary to diagnose COVID-19. You can submit a claim for reimbursement electronically by logging in to myBCBSRI.com.

Yes, home test kits can be purchased with your quarterly OTC allowance ($25-$275, available with most BCBSRI Medicare Advantage plans). We recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed.

To use your quarterly OTC benefit, you must buy the home test kits in store through the national retailers in your OTC network: Walmart, Dollar General, Family Dollar, Rite Aid, Walgreens, and CVS Pharmacy^®.