On January 10, 2022, guidance was issued stating that individuals who purchase OTC COVID-19 tests (or at home tests) beginning January 15, 2022, through the public health emergency period, will be able to seek reimbursement for the cost of the test from their group health plan without a healthcare provider order or individualized clinical assessment.
For more information – please see the FUNDS FLASH PDF. CLICK HERE to download an ESI claim form.
The Health & Welfare Team is actively working with the Fund’s Prescription Benefit Manager (PBM), Express Scripts (ESI), to provide direct-to-consumer coverage through our network and mail order pharmacies. In the meantime, individuals can get OTC tests in two ways:
- The Fund will reimburse eligible individuals (excluding United Healthcare) for certain tests purchased – as long as they are purchased at the retail pharmacy counter, by submitting a paper claim to ESI that includes the appropriate national drug code (NDC) number. A claim form is attached and is available on our website (see below); or
- Free tests can be requested from the Federal government at https://www.covidtests.gov.
