Consumer Alert: Free COVID tests. Your questions answered

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ROCHESTER, N.Y. (WHEC) — The government’s website for free COVID tests is now officially up and running. It seems the process of getting free at-home COVID tests is a bit more complicated than the government anticipated. The devil is always in the details. So I caught the devil by the tail and I’m getting you answers.

Let’s start with this tweet we got last night. One viewer wrote, “Glitch in free COVID testing ordering process. Doesn’t recognize apartments as separate residences.”

So what’s happening in some cases, one person in the apartment building would place an order and the system would reject everyone else who tried to order, believing that residence had already ordered their allotted number of tests.

I reached out to USPS Tuesday night, and I got a response at 3:22 Wednesday morning. It looks like those folks aren’t getting much sleep. David Partenheimer wrote, "The Postal Service is seeing very limited cases of addresses that are not registered as multi-unit buildings which could lead to COVID test kit ordering difficulties. This is occurring in a small percentage of orders. For assistance in the ordering process, the USPS recommends filing a service request online or contacting our help desk at 1-800-ASK-USPS.

So far every viewer we’ve given this information has gotten their issue resolved. Remember you get four tests per household, and tests should be shipped in seven to 12 days.

Here are more viewer questions:

QUESTION: Insurance will reimburse you for eight COVID tests per month. What if there are two tests in one box?
ANSWER: That one box will count as two tests.

QUESTION: My insurance covers my spouse and children. Will my insurance reimburse me for eight tests a month for *each* of us?
ANSWER: Yes. That means if you have a spouse and two children. Most insurers will cover 32 tests per month.

QUESTION: Can I buy all eight COVID tests at one time?
ANSWER: I asked insurers. Their answer is yes.

QUESTION: What do I need to show proof of purchase?
ANSWER: In some cases, you just need the receipt. But other insurers require the receipt and the UPC from the box. So if in doubt, submit both.

QUESTION: What about Medicaid?
ANSWER: According to the state’s Medicaid website, New York mandates that Medicaid recipients be reimbursed for one at-home test per week if you have a fiscal order, like a prescription, from a Medicaid-enrolled practitioner. But if you have Medicare, you’re likely out of luck. Original Medicare does not reimburse for at home tests and most plans don’t reimburse for Medicare advantage.

Some insurers like United and Fidelis are making it easier for members. Both have a preferred list of pharmacies. So if you get your test from one of those pharmacies, you can get it with no upfront cost, no paperwork, and hassle-free.

Dewberry asked three insurers popular in the Rochester area the following questions.

MVP Healthcare:

QUESTION: Your website indicates that members can get reimbursed for up to eight tests every 30 days. If there are two tests in one kit, does that count as one test or two?
ANSWER: If there are two tests in one kit, that counts as two of the eight tests eligible for reimbursement.

QUESTION: Other insurers have preferred retailers where members can get the kit for free without having to submit a form for reimbursement. Is that the case with MVP? If yes, would you provide a link to the retailers?
ANSWER: We are currently working to implement this requirement so that our members do not have to pay out of pocket at a preferred retailer.

QUESTION: Do members need to submit a separate reimbursement form for each test? For example: If a member bought all eight tests at once, can that member submit one form for eight tests?
ANSWER: Yes, members can submit for reimbursement for multiple tests on one form. However, specific requirements need to be met for reimbursement including, but not limited to, receipts and UPC codes from the test box.

QUESTION: Is this the correct reimbursement form for reimbursement of at-home COVID tests?
ANSWER: MVP members with employer-sponsored or individual insurance can use our medical or pharmacy reimbursement form here and MVP members with Medicaid insurance can use our Prescription Reimbursement Claim Form but are encouraged to work with their in-network preferred retailer to obtain kits at no up-front costs.

Excellus Blue Cross Blue Shield:

QUESTION: Your website indicates Excellus BCBS does not have a provider list where members can get a free test kit without having to submit a reimbursement form. Therefore, a reimbursement form and receipt must be submitted for each test kit – correct?
ANSWER: Members will be able to submit a paper claim for reimbursement. We’ll share details soon on ChooseExcellus.com/COVID19 regarding how to submit the claim for reimbursement. In the meantime, members should save their receipts and the boxes the tests came in. We’ll be sharing the form soon on ChooseExcellus.com/COVID19. We’re also evaluating the feasibility of setting up a network of pharmacies where members could acquire the tests without having to pay for the cost upfront.

QUESTION: The website indicates that members can get up to eight tests every 30 days. It also indicates a member can buy all eight at one time. Does the member have to submit a separate form for each test?
ANSWER: If a member purchases all eight tests at one time, the member will be able to submit one reimbursement form for the entire purchase.

Fidelis:

QUESTION: Your website indicates that you Medicaid members can get up to eight free tests a month WITH A DOCTOR’S PRESCRIPTION from an in-network pharmacy. Is that correct?
ANSWER: Yes, current Medicaid guidelines require a prescription for an at-home test.

QUESTION: Medicaid members have questions about the process. Do they need to give the prescription to the pharmacist to get the free test?
ANSWER: Yes, current Medicaid guidelines require a prescription for an at-home test. Members will need to present a prescription at the point of sale, or have their doctor send the prescription to the pharmacy.

QUESTION: Medicare’s website indicates that SOME Medicare Advantage members may be reimbursed. Is Fidelis reimbursing Medicare Advantage members? If so, do the same rules apply as for those with Medicaid?
ANSWER: At this time, Wellcare By Fidelis Care is not reimbursing Medicare Advantage and Dual Advantage members for COVID-19 at-home testing kits purchased independently online or from a retailer. We encourage members to receive COVID-19 tests at official testing sites by health care professionals at no cost. As part of the new federal government website, members are also eligible to order four free at-?home COVID-?19 tests from covidtests.gov. Medicaid members can be reimbursed up to $25/per kit for Medicaid-covered at-home COVID tests in accordance with Medicaid benefit coverage requirements.

QUESTION: It appears at CVS is an in-network pharmacy. Can you send a link to others?
ANSWER: Members can find an in-network pharmacy using our Find a Doctor tool accessed by visiting fideliscare.org/find-a-doctor.