COVID-19 Diagnostic Testing through BCBS

Thursday, February 10, 2022

This is a benefit for employees who are enrolled in Carroll's medical insurance through Blue Cross. It provides for the following and there is a claim form that would need to be submitted by the health plan participant.

  • Starting Jan. 15, 2022, coverage for at-home COVID-19 diagnostic OTC tests is required for all Blue Cross and Blue Shield of Montana (BCBSMT) fully insured and self-insured groups, and individual and family plans
  • Requires group health plans and issuers to cover COVID-19 diagnostic OTC tests without a prescription or health assessment from a provider
  • Coverage must be provided:
    • Without cost-share, up to $12 per test under the safe harbor (for plans that provide access to the tests through a pharmacy network and direct-to-consumer shipping program, with no up-front cost to the member)
    • Without prior authorization or medical management techniques
    • OTC tests purchased prior to Jan. 15, 2022, are not in scope
  • Allows coverage of eight (8) tests per covered member, every 30 days (or, for example, 4 boxes with 2 tests per box)
  • Coverage is effective through the end of the federal public health emergency
  • At-home testing for employment purposes is not considered a covered benefit under this federal guidance
  • If you are requesting reimbursement for a COVID home test kit, a cash register receipt is valid. For these test kits there may not be an Rx#, leave blank, the rest of the information is required. An NDC or UPC code can be used. IMPORTANT: Your signature is required that you attest that these test kits are not being used for testing required by your employer, return to work, travel, attending recreational event requirements, and will not be resold.

For questions, please contact Director of Human Resources Karla Smith, 406-447-5501 or klsmith@carroll.edu.