Following the federal government public notice requiring commercial health plans to cover up to eight over-the-counter (OTC) COVID-19 tests per month per covered individual for diagnostic purposes, starting Jan. 15, Cigna has announced their coverage process for the OTC COVID-19 antigen tests for all U.S. commercial customers and their respective members enrolled in the medical benefit.
Coverage and reimbursement details can be found here and summarized below:
- Employees covered by Texas Children’s Cigna medical plan may receive reimbursement for up to eight FDA authorized OTC COVID-19 at-home tests per covered individual on the plan per 30-days without a health care provider prescription or individualized clinical assessment.
- Each individual test is counted separately – so, if a package includes eight tests, it counts as eight tests, and not one, toward the quantity limit.
- Cigna will reimburse the costs of OTC tests purchased on or after Jan. 15, 2022, regardless of where it was obtained (including online, in- and out-of-network).
- Employees or their covered members can get an authorized test kit at any pharmacy (in- or out-of-network), retail store or online retailer.
- COVID-19 testing performed by health care providers is not subject to a quantity limit.
Covered employees may also go to Cigna.com, MyCigna.com or the MyCigna app to access detailed instructions on the reimbursement process and to a view more information, including FAQs. Please click here for the COVID-19 Over-the-Counter (OTC) Test Kit Claim Form.
For employees and medical staff covered by Baylor’s medical/pharmacy plans United HealthCare and CVS/Caremark, please check the Baylor intranet site for plan coverage details and reimbursement information.
For members of Express Scripts mail order services, they are currently working on a solution designed to meet mandate requirements and we will keep you updated when we learn more.
Every home in the U.S. is eligible to order four free at-home COVID-19 tests, please visit https://special.usps.com/testkits.
As we work as an organization and community to protect ourselves, each other and our patients against the surge in COVID-19 Omicron cases, we appreciate your commitment to this effort and by taking advantage of these additional testing opportunities as needed. Ongoing updates can be found on the COVID-19 Vaccine website and in this FAQ document.