Recently, federal regulators have issued issued guidance regarding mandatory coverage of at-home or over-the-counter COVID-19 diagnostic tests.
Detroit Mercy’s health plan will provide direct coverage, whether it’s by the pharmacy benefit manager (PBM) at point of sale of via a claims reimbursement.
Plan participants also have the option for a mail order program. Tests can be ordered through the government’s website.
Any claims submitted under the medical plan will be denied by Trustmark, as claims must be submitted under the prescription plan. For OTC COVID-19 tests, plan participants are limited to eight tests per 30 days or calendar month. Under the plan out-of-network reimbursement is limited to $12 per test.
All receipts should also be saved as they are required for reimbursement.