Over-the-Counter COVID-19 Test Coverage

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. This new 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.

Insurers are incentivized to work with preferred pharmacies to remove upfront costs for members. If insurers do not set up a preferred pharmacy network will have to cover more of the costs.

General information:

 

We are pending information from Cigna + Oscar.

Information for additional medical carriers:

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