The Public Health Emergency (PHE) for COVID-19 will expire at the end of the day on May 11, 2023, however Federal Plans will continue offering over-the-counter (OTC) COVID-19 tests.
Here’s what you need to know
Beginning May 12, 2023, and in line with guidance recently issued by the Office of Personnel Management (OPM), Aetna Federal Plans will provide coverage for 8 OTC COVID-19 tests per rolling 30 days and other preventive COVID liberalizations as outlined below.
What’s covered?
We’ll cover up to eight COVID-19 diagnostic antigen rapid home tests per 30-day period for each person covered under your plan. For example, a family of four covered under the same plan will be reimbursed for up to 32 tests per 30-day period.
In addition, the Plan will continue to cover diagnostic COVID testing at the lab and COVID related services at inpatient hospital, but normal cost sharing will apply. We will also continue coverage for COVID-19 vaccines (including their administration), and any other qualifying coronavirus preventive services intended to prevent or mitigate COVID-19 on an in-network basis without cost sharing.
How do I get my tests covered?
Members can submit a claim for reimbursement to:
Aetna Pharmacy Management
PO Box 52444
Phoenix, AZ 85072-2444
Or submit via fax to 1-888-472-1128
Prescription Drug Claim Form (PDF)Where can I find at-home COVID-19 tests?
You can buy at-home COVID-19 tests at pharmacies, retail locations or online. Remember to keep your receipts.
Things to remember:
- Aetna will cover up to eight over the counter (OTC) at-home COVID-19 tests per 30-day period for each person covered under your plan. Note: Each test is counted separately, even if multiple tests are sold in a single package. (For example, BinaxNOW™ offers a package with two tests included. That would count as two individual tests.)
- Tests must be approved, cleared or authorized by the U.S. Food and Drug Administration (FDA).
- You can only get reimbursed for tests purchased on January 15, 2022, or later.
- These tests don’t require an order from your physician to qualify for reimbursement. Tests ordered by a provider aren’t subject to the frequency limit.
- Tests must be used to diagnose a potential COVID-19 infection. Tests used for employment, school or recreational purposes are not eligible for reimbursement unless required by state law.
