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March 2022

Blue Cross and BCN revise at‑home COVID‑19 testing policy

What you need to know
On Jan. 19, the federal government launched COVIDtests.gov,** a website where every home in the U.S. is eligible to order four at-home COVID-19 tests for free. The government says orders usually ship in seven to 12 days and will be delivered by the U.S. Postal Service.

There’s also a way for Blue Cross Blue Shield of Michigan members with Blue Cross or Blue Care Network pharmacy coverage to obtain free tests using some new options. This article provides details.

We’ve revised the at-home COVID-19 testing policy for Blue Cross and BCN commercial plans to comply with Affordable Care Act FAQs issued Jan. 10, 2022.** The new policy is in effect through the public health emergency.

Commercial members with pharmacy coverage through Blue Cross or BCN have coverage for up to eight FDA-authorized, over-the-counter at-home rapid diagnostic COVID-19 tests per month. The at-home COVID-19 tests can be obtained in two ways:

  • Through our preferred COVID-19 at home testing pharmacy network at no cost to the member
  • Through non-preferred pharmacies by paying the full amount up front and then requesting reimbursement by submitting a claim form, along with a copy of the receipt. The member would request reimbursement of $12 or the cost of the at-home COVID-19 test, whichever is lower.

Commercial members who don’t have pharmacy coverage through Blue Cross or BCN should contact their employer for details about how they can obtain qualified at-home tests.

To view a list of in-network pharmacies and the reimbursement process for COVID-19
at-home tests, visit our COVID-19 webpage for individuals and families.

These new at-home COVID-19 testing guidelines don’t apply to Medicare Advantage plans.

Reminder about in-person COVID-19 testing

Our commercial plans continue to pay for other types of COVID-19 testing, other than rapid at-home testing, if they meet these criteria:

  • The test has received or is waiting to receive approval for use (including emergency use) by the FDA or falls within one of the other categories of tests required to be covered by the Families First or CARES Acts.
  • The test is administered or ordered by a qualified health professional who determines testing is appropriate using judgment in accordance with accepted standards of medical practice through an individualized clinical assessment.

Blue Cross and BCN don’t cover testing performed only for occupational indications.

For more information

For more information, refer to the COVID-19 patient testing recommendations for physicians document, which has been updated to reflect this new at-home testing policy. This document can be found on our public website at bcbsm.com/coronavirus or within Provider Secured Services by clicking on Coronavirus (COVID-19).

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.