PacificSource has provided us the following information:
Effective January 15th, commercial insurers and plan sponsors will be required to cover up to 8 at-home COVID tests per covered individual per month, while federal Public Health Emergency orders remain in place. Reimbursement for non-participating pharmacies or other retailers will be the purchase price or $12 per test, whichever is the lower. This limitation does not apply to tests administered with a provider’s involvement or prescription.
Additionally, insurers are strongly encouraged to provide zero-cost share coverage at the pharmacy, reducing or eliminating the need for members to pay upfront and seek reimbursement.
What PacificSource is doing to comply with this new requirement:
- We are currently working with Pharmacy Services and CVS to determine what options we will have available for our Commercial members at the pharmacy and will be providing additional information as soon as possible.
- The reimbursement process is being confirmed internally including what form a member should use for reimbursement and preparing our claims teams for an uptick in manually submitted claims.
Thank you for your patience as we work through this latest requirement.
Learn more about what PacificSource is doing tied to Coronavirus: