Purchase and Reimbursement Process
As just recently announced, at-home COVID-19 test(s) will now be a covered benefit. Since this is a recently added benefit, providers and plans are newly preparing for the processes to run smoothly. At this time, members will purchase the at-home COVID-19 test(s) and submit a copy of their receipt for reimbursement for up to $12 per test. Be aware of the cost that you pay at the counter, since the maximum limit is $12 per test. Quantity limits are no more than eight tests per 30 consecutive days.
In the future, processes will provide for the member to go to the pharmacy and obtain the at-home COVID-19 test(s) by presenting their member card, and then the pharmacy will bill WVCHIP for the test(s). Many pharmacies were already facing staffing shortages and additional work in providing vaccinations, and many have simply determined that they cannot take on this extra responsibility for processing claims for over-the-counter test(s). Since it is up to individual pharmacies to determine how to handle these at-home test claims, we will announce any updates on this site under the Announcements section, as soon as they become available.
Current process for reimbursement: Members login to Caremark.com and can upload a copy of their purchase receipt for the over the counter at-home COVID-19 test(s), purchased on or after January 15, 2022. There are instructions upon logging in to the site. CVS/Caremark is observing a seamless experience for online receipt submission of member-purchased OTC at-home COVID-19 tests. Below is a specific link for OTC COVID-19 test reimbursement that provides more information for members, including a frequently asked questions section at the bottom.