Amwins Connect Coronavirus (COVID-19) Resources

The Coronavirus (COVID-19) pandemic has introduced the need to take immediate action to ensure the health and well-being of ourselves, and our families. As insurance industry professionals, this outbreak has also raised a host of questions that continue to evolve daily.

As your dedicated partner, we understand that you need access to information quickly. That’s why we’ve prepared this resource to ensure you have the resources and support you need during this time. We are monitoring this situation vigilantly and we encourage you to bookmark this page and check back often for updates.

Stay updated with all the COVID-19 news!

COVID-19 News

No Cost Over-the-Counter COVID Tests

As of January 15, 2022, health plans are required to cover the cost of 8 FDA approved over-the-counter (OTC) in-home diagnostic tests, per member per month. The guidance is applicable to self-insured and fully insured group health care plans, including grandfathered health plans (“plans”):

Plans and issuers must cover the cost of OTC COVID-19 tests, including tests obtained without a health care provider’s order or authorization.
Coverage must be provided without cost-sharing (deductibles, co-payments, and coinsurance) or prior authorization requirements.
Plans must reimburse participants for the cost of testing per the plan’s claims procedures. Plans are not required to reimburse sellers of the kits directly but may do so voluntarily.
- The guidance “strongly encourages” plans to provide direct coverage for OTC COVID-19 tests by reimbursing sellers directly without requiring participants to seek reimbursement.

CARRIER	CLAIM SUBMISSION PROCESS	RETAIL PURCHASE WITHOUT CLAIM SUBMISSION	RESOURCES
Banner\|Aetna	Members can submit for reimbursement through Banner\|Aetna's member portal.	Members can show their ID card to a network pharmacy to receive the test at no cost. Note that not all network pharmacies are prepared to process through insurance at this time; if the pharmacy is unable to process then members can purchase the test and submit for reimbursement.	COVID Resource Center At Home Test Flyer
Blue Cross Blue Shield of Arizona	Members must mail a completed OTC Home Test Reimbursement Form along with their UPC barcode label from the test package.	Not available at this time.	OTC Home Test Reimbursement COVID Resource Center
Cigna Administered by Oscar	Members can obtain tests through Cigna + Oscar’s Direct Coverage program.	C+O recommends members show their ID card to the pharmacy and request they will your insurance. They understand this may not be accepted as many pharmacies are still working through how to set up this process.	OTC Home Test Reimbursement
Humana	Members must mail a completed OTC Test Reimbursement Form along with the original itemized receipt to the address on the back of the members ID card.	Members can show their ID card to a network pharmacy to receive the test at no cost. Note that not all network pharmacies are prepared to process through insurance at this time; if the pharmacy is unable to process then members can purchase the test and submit for reimbursement.	OTC Test FAQs
UnitedHealthcare	Members can submit for reimbursement through UHC's member portal.	Members who have pharmacy benefits administered by OptumRx will have no up-front cost when purchasing through Walmart Pharmacy or Rite Aid Pharmacy (members can determine they are through OptumRx by the logo on their ID card). UHC is working to add additional retailers.	OTC Home Testing FAQ COVID Resource Center

CARRIER	CLAIM SUBMISSION PROCESS	RETAIL PURCHASE WITHOUT CLAIM SUBMISSION	RESOURCES
Aetna	Members can submit for reimbursement through Aetna's member portal.	Members can show their ID card to a network pharmacy to receive the test at no cost. Note that not all network pharmacies are prepared to process through insurance at this time; if the pharmacy is unable to process then members can purchase the test and submit for reimbursement.	OTC Home Testing Reimbursement FAQs At Home Test Flyer
Anthem Blue Cross	Members can submit for reimbursement through Anthem's member portal (select Claims & Payment after logging in). Members can also order tests online using the Sydney Health mobile app or at anthem.com/ca.	Not available at this time.	Article on OTC Tests
Blue Shield of California	Members can submit for reimbursement using the Blue Shield Statement of Claim form.	Not available at this time.	How to File a Reimbursement COVID Testing Grid
Cigna + Oscar	Members can obtain tests through Cigna + Oscar’s Direct Coverage program.	C+O recommends members show their ID card to the pharmacy and request they bill your insurance. They understand this may not be accepted as many pharmacies are still working through how to set up this process.	OTC Home Test Reimbursement
Health Net	Members can submit for reimbursement using the Health Net claim form.	Not available at this time.	-
Kaiser Permanente^®	Members can submit for reimbursement through Kaiser's member portal. To submit, select "Coverage & Costs", then select "Submit a medical claim".	Members may visit a participating retail pharmacy, such as Walmart and Rite Aid, to pick up tests at no cost. Visit kp.org to see a list of participating retailers. Members will need to present their photo ID and Kaiser ID card at the pharmacy counter. Availability of tests may vary.	COVID Resources
MediExcel Health Plan	A claims reimbursement process will be available soon.	Not available at this time. MediExcel hopes to have resources available soon.	COVID Resources
Sharp Health Plan	Members can submit for reimbursement using the Sharp OTC COVID test reimbursement form.	Not available at this time.	COVID Resources
Sutter Health Plus	Members can submit for reimbursement using the Sutter claim form.	Not available at this time.	COVID Resources COVID Member Flyer
UnitedHealthcare	Members can submit for reimbursement through UHC's member portal.	Members who have pharmacy benefits administered by OptumRx will have no up-front cost when purchasing through Walmart Pharmacy or Rite Aid Pharmacy (members can determine they are through OptumRx by the logo on their ID card). UHC is working to add additional retailers.	OTC Home Testing FAQ COVID Resource Center
Western Health Advantage	A Claim Reimbursement webpage is available through the WHA Pharmacy partner OptumRx and will accept receipts dated on or after January 15, 2022.	Members may visit a preferred network pharmacy to receive tests at no cost. Preferred network locations will be updated as more become available; check the WHA COVID page for a current list.	COVID Testing Reimbursement Letter

CARRIER	CLAIM SUBMISSION PROCESS	RETAIL PURCHASE WITHOUT CLAIM SUBMISSION	RESOURCES
Aetna	Members can submit for reimbursement through Aetna's member portal.	Members can show their ID card to a network pharmacy to receive the test at no cost. Note that not all network pharmacies are prepared to process through insurance at this time; if the pharmacy is unable to process then members can purchase the test and submit for reimbursement.	OTC Home Testing Reimbursement FAQs At Home Test Flyer
Anthem (CT & NH)	Members can submit for reimbursement through Anthem's member portal (select Claims & Payment after logging in). Members can also order tests online using the Sydney Health mobile app.	Not available at this time.	OTC Testing Coverage
BCBSRI	Members can submit a completed reimbursement form along with the receipt for reimbursement.	Members can visit a pharmacy in the BCBSRI pharmacy network to receive a test at no-cost. Note: not all pharmacies are ready to process requests and members may need to submit for reimbursment.	OTC Testing Coverage
Cigna + Oscar (CT)	Members can obtain tests through Cigna + Oscar’s Direct Coverage program.	C+O recommends members show their ID card to the pharmacy and request they will your insurance. They understand this may not be accepted as many pharmacies are still working through how to set up this process.	OTC Home Test Reimbursement
EmblemHealth	Members can submit for reimbursement through EmblemHealth's online prescription reimbursement site; must include receipt.	Not available at this time.	COVID Testing Claim Form Instructions
Empire BlueCross BlueShield	Members can submit for reimbursement through Empire's member portal (select Claims & Payment after logging in). Members can also order tests online using the Sydney Health mobile app.	Not available at this time.	OTC Testing Coverage
Harvard Pilgrim HealthCare	Members must mail a completed At-Home Test Reimbursement Form along with a copy of the receipt for reimbursement.	Commercial members can visit a Walmart of Rite Aid Pharmacy and purchase tests with no upfront cost.	COVID Guide to Care
Healthfirst	Members should call Healthfirst Members Services at 1-888-250-2220 for help with reimbursement.	Members can visit a pharmacy in the Healthfirst pharmacy network to receive a test at no-cost.	OTC Testing Coverage
UnitedHealthcare & Oxford	Members can submit for reimbursement through UHC's member portal.	Members who have pharmacy benefits administered by OptumRx will have no up-front cost when purchasing through Walmart Pharmacy or Rite Aid Pharmacy (members can determine they are through OptumRx by the logo on their ID card). UHC is working to add additional retailers.	OTC Home Testing FAQ COVID Resource Center