Your Benefits

Effective 1/15/2022 Iron Road Healthcare will cover at-home COVID antigen tests

January 14, 2022 — Tonya Hayes

Updated 1/19/22

For Non-Medicare Members

Iron Road Healthcare will cover up to 8 at home COVID tests per person per month.

If you use your pharmacy benefit (plan insurance card) to purchase an at-home COVD test at any Walmart, Rite Aid, Walgreens, Kinney Drugs or Sam’s Club pharmacy the entire cost of the test will be covered and there will be no need to submit any receipt for reimbursement or out of pocket cost. If you purchase an at-home COVID test without using your insurance card at any Walmart, Rite Aid, Walgreens, Kinney Drugs or Sam’s Club pharmacy, you will need to submit the receipt and the tests will be reimbursed up to $12.00 per test. You will be responsible for any difference. You may submit your receipts online at my.irhc.com. The availability of at-home COVID tests in a local pharmacy maybe limited due to supply issues.

For Medicare Members

HHS is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program here. The Biden-Harris Administration is purchasing 500 million at-home, over-the-counter tests to be distributed for free to Americans who want them, with the initial delivery starting in January 2022. There will be a website where all Americans can request at-home tests for home delivery for free. More information on this federal program is expected soon. Iron Road Healthcare and Depot Drug will not supply at home tests or reimburse costs, as Medicare is the primary insurance and pays in full.

Get free at-⁠home COVID-⁠19 tests

Every home in the U.S. is eligible to order 4 free at-⁠home COVID-⁠19 tests from the government. The tests are completely free. Orders will usually ship in 7-12 days. Order your tests now so you have them when you need them. The government website to place orders is COVIDtests.gov If you need a COVID-⁠19 test now, please see other testing resources for free testing locations in your area.

Frequently Asked Questions:

I’m covered by Medicare. How do I get an at-home over-the-counter COVID-19 test?

HHS is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program here. HHS also has established more than 10,000 free community-based pharmacy testing sites around the country. To respond to the Omicron surge, HHS and FEMA are creating surge testing sites in states across the nation. The Biden-Harris Administration is purchasing 500 million at-home, over-the-counter tests to be distributed for free to Americans who want them, with the initial delivery starting in January 2022. There will be a website where all Americans can request at-home tests for home delivery—for free. More information on this federal program is expected soon.

For people covered by original fee-for-service Medicare, Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People with Medicare can access one lab performed test without cost sharing per patient per year without an order. At this time original Medicare cannot pay for at-home tests through this program. Medicare Advantage plans may offer coverage and payment for at-home over-the-counter COVID-19 tests, so consumers covered by Medicare Advantage should check with their plan.

What if I buy more than one test at a time?

Your plan is required to provide reimbursement for 8 tests per month for each individual on the plan, regardless of whether the tests are bought all at once or at separate times throughout the month.

What if I already bought and paid for at-home over-the-counter COVID-19 tests? Can I still get reimbursement for those?

Plans and insurers are required to cover at-home over-the-counter COVID-19 tests purchased on or after January 15, 2022. Plans or issuers may, but are not required by federal law to, provide such coverage for at-home over-the-counter COVID-19 tests purchased before January 15. Contact your health plan to inquire about getting reimbursed for tests purchased before January 15, 2022. Some states may have existing requirements related to coverage of at-home over-the-counter COVID-19 tests.

Topics: Your Benefits

Written by

Tonya Hayes

0 Responses

Write a Response

*Required Information

Never miss a story.

We'll send you our favorite articles once in a while to keep you informed.