News & Updates
Aetna provided the following information to their small group plan sponsors regarding coverage for OTC COVID-19 tests. Click here for a PDF version of this information from Aetna.
Summary of requirements
On January 10, the Biden Administration issued guidance requiring all group health plans and health insurers to cover OTC COVID-19 tests without member cost share effective January 15, 2022.
The new OTC coverage requirement:
Note: This mandate is in effect until the end of the federal public health emergency. Any tests purchased pursuant to a physician’s order will not be subject to the quantity limit.
Aetna's strategy for compliance
While Aetna can administer the required coverage of OTC COVID-19 tests in various ways, due to the urgency of this mandate, Aetna has made the decision to cover OTC tests under the pharmacy benefit.
Aetna is immediately implementing the strategy below for your pharmacy plan to help ensure you have a path to compliance beginning January 15, 2022.
Next week, Aetna will contact plan sponsors about the direct coverage option and provide details for members to submit direct reimbursement claims. They will include a proposed member communication.
For questions, please contact a member of your B&P Sales Team - 888.722.3373.