OTC COVID-19 Antigen Tests FAQ

Refer to the U.S. Food & Drug Administration on tests that are eligible for coverage.

For members with Aetna pharmacy benefits, you can submit a claim for reimbursement through your Aetna® member website.

For members with CVS Caremark pharmacy benefits or whose employer covers these tests under medical benefits, you should expect a response within 30 days. If your reimbursement request is approved, a check will be mailed to you.

When you submit your claim, you’ll need to include:

  • Who the tests are for (self or dependent)
  • The number and type of tests purchased
  • Date of purchase
  • Price of purchase
  • A copy of your receipt

You’ll also be asked to attest that the OTC kit is for personal use only, and not for employment, school, recreational or travel purposes.

OTC COVID-19 tests can be purchased at pharmacies, retail locations or online. Due to high demand for OTC at-home COVID-19 tests, supplies may be limited in some areas.

To help improve access to these tests, the Biden-Harris Administration is expanding access to free at-home kits through the federal government. Visit www.covidtests.gov to learn more.

If you have private, employer-sponsored or student health commercial insurance you’re eligible to get reimbursed for over-the-counter at-home COVID kits. You are not eligible if you have Medicare, Medicare Supplement, Medicaid, or voluntary insurance.

  • Aetna will cover up to eight (8) over the counter (OTC) at-home COVID-19 tests per 30- day period for each person covered under your
  • 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 S. Food and Drug Administration.
  • You can only get reimbursed for tests purchased on January 15, 2022 or
  • These tests don’t require an order from your physician to qualify for reimbursement, although tests ordered by a provider aren’t subject to the frequency
  • Tests must be used to diagnose a potential COVID-19 infection. Tests used for employment, school or recreational purposes are not eligible for

Coverage is in effect, per the mandate, until the end of the federal public health emergency

Your health plan will have the best information on how to buy OTC COVID-19 tests that will be covered.

Some pharmacies may not be able to process claims for OTC COVID-19 tests at the pharmacy counter. If this happens, you can pay for the test, then submit a request for reimbursement.

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