The Oklahoma Insurance Department issued a special notice regarding coverage of at-home, over-the-counter (OTC) COVID-19 tests.
Beginning January 15, group health plans and health insurance issuers offering group or individual health insurance coverage must cover OTC COVID-19 tests. Under the new guidelines, the tests may either be free or reimbursed by the insurer.
Health plans and insurance companies are incentivized to set up a network of pharmacies or retailers so their members can conveniently order or pick up COVID-19 tests that will be covered up-front. OID requested that all regulated insurance companies provide a description of how the administration of coverage for at-home OTC COVID-19 tests will be handled and communicated to their insureds and members.
“Like the rest of the nation, Oklahoma is facing a new surge with the omicron variant. Continued testing is critical to fighting the COVID-19 pandemic and ensuring the health and safety of our communities,” Insurance Commissioner Glen Mulready said. “I encourage Oklahomans to take advantage of at-home testing and available local testing sites to help keep people safe with early detection.”
If you purchase an over-the-counter COVID-19 test from a pharmacy, store, or online retailer and are charged for your test, keep your receipt and submit a claim to your insurance company for reimbursement. If your plan has not set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, consumers will be reimbursed the amount of the cost of the test.
For example, if you buy a two-pack of tests for $34, the plan or insurer would reimburse $34. If your plan has set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers if you buy them outside of that network. Your plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Save your receipt(s) to submit to your plan for reimbursement at a rate of up to $12 per individual test (or the cost of the test, if less than $12).
For questions about other insurance issues, contact the OID at 1-800-522-0071 or visit www.oid.ok.gov.