Highmark prepared to reimburse members for over-the-counter COVID tests

Members can begin seeking reimbursement for tests purchased on or after Jan. 15

PITTSBURGH (January 14, 2022) — The Biden Administration announced new federal guidance on Jan. 10, 2022 that people with employer-sponsored or individual health insurance coverage can seek reimbursement for the purchase of over-the-counter COVID-19 tests from their employer group or health insurer effective Jan. 15.  

Over-the-counter, at-home, diagnostic tests that are approved by the FDA can qualify for reimbursement. Per federal guidelines, Highmark members can seek reimbursement for up to 8 qualifying tests per month.

“Highmark is committed to putting our customers first,” said Thomas Doran, executive vice president and chief operating officer for Highmark Inc. “Throughout the pandemic, we have made it a priority that our members have access to COVID testing, treatment and vaccines because we know these are important tools for keeping our members and our communities healthy and safe. We are prepared to process reimbursement requests beginning on Jan. 15 so that our members have access to diagnostic testing without any financial barriers.”

To get reimbursed, Doran said members should submit a manual claim form through the member portal, located at highmarkbcbs.com, and upload a copy of their receipt and UPC label from the test. Highmark is also working to have additional options for members to get reimbursed, or to purchase a test from a participating pharmacy or retailer without any up-front costs.

The Biden Administration did not include Medicare in this guidance, noting that at this time, Medicare cannot pay for at-home tests through this program. Highmark’s Medicare Advantage members, however, can continue to have access to COVID-19 testing at no cost when ordered by a clinician, Doran said. 

Highmark is encouraging anyone with questions about the federal guidance or the reimbursement process to visit its informational website highmarkanswers.com for the latest updates.