OTC COVID-19 Tests

OTC COVID-19 tests are FDA-authorized COVID-19 diagnostic tests that are used and processed at home. 

 

Fund Coverage for OTC COVID-19 Tests

Important: Coverage is not provided for anything employment-based or for non-personal use, or for resale.

The Fund will cover OTC COVID-19 tests without an order or individualized clinical assessment by a health care provider.

The limit of coverage per covered Person is eight (8) OTC COVID-19 tests per month. Each test is counted separately, even if multiple tests are sold in one package.

Coverage is for purchases of OTC COVID-19 tests on or after January 15, 2022.

 

Direct Coverage Method

By presenting the CVS Caremark prescription drug card, Active Employees (and their Dependents) and Retirees not Eligible for Medicare (and their Dependents not Eligible for Medicare) can obtain the OTC COVID-19 tests at no cost* at a pharmacy in the CVS Caremark national network of over 67,000 pharmacies or through a direct ship method with a Network Pharmacy. For more information on the Direct Coverage Method, please click here.

*If a Network Pharmacy or their website in unable to directly process the OTC COVID-19 test at no up-front cost, or the pharmacy does not have any OTC COVID-19 tests available, then a covered Person can:

  • Try a different Network Pharmacy or website
  • Pay out of pocket and then submit a claim for reimbursement at www.caremark.com or use the form linked below (paper reimbursement form is also available at https://www.neca-ibew.org/Documents-and-Forms).
  • Retirees Eligible for Medicare and their Medicare-Eligible Dependents are currently not eligible for the direct coverage method or use of the CVS Caremark online reimbursement claim portal. Retirees and Dependents in this category must use the paper form process for reimbursement. The Federal Government has announced that Medicare will be directly covering OTC COVID-19 Tests in the Spring of 2022.

The maximum reimbursement for tests obtained outside of the direct coverage method is $12 per test.

How to Get Reimbursed for OTC COVID-19 Tests

Active Employees (and their Dependents) and Retirees not Eligible for Medicare (and their Dependents not Eligible for Medicare)

  • Go to www.caremark.com
  • Click on the link that says, "request your reimbursement' (See example below. The link placement on the Caremark website is subject to change)

 caremark1.jpg

  • If you have an account with www.caremark.com, click on the Sign in box
  • If you do not have an account, you must register and create an account on www.caremark.com before you can request reimbursement; click on the Register Now link
  • When you are signed in, click on Request Your Reimbursement
  • Complete the form

OR

Retirees Eligible for Medicare and their Medicare-Eligible Dependents

 

OTC COVID Test Paper Claim Form

CVS OTC Test Claim Form.jpg

 

Free Tests Available from the U.S. Government

In addition to Fund coverage, any person can visit www.covidtests.gov to order 4 free at-home COVID-19 tests. Every home in the United States is eligible to order 4 free at-home COVID-19 tests.

These tests are free under the government program and are not reimbursable through the Fund.