Friday, January 14, 2022
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.
About Highmark Inc.
One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to deliver high-quality, accessible, understandable, and affordable experiences, outcomes, and solutions to customers. As the fourth-largest overall Blue Cross Blue Shield-affiliated organization, Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of more than 6 million members in Pennsylvania, Delaware, West Virginia and New York. Its diversified businesses serve group customer and individual needs across the United States through dental insurance and other related businesses. For more information, visit www.highmark.com.
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Highmark Health
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aaron.billger@highmarkhealth.org
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All references to “Highmark" in this document are references to the Highmark company that is providing the member's health benefits or health benefit administration and/or to one or more of its affiliated Blue companies. This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. It also does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
Highmark Blue Cross Blue Shield or Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal. ®Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life, Highmark Wholecare or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company, Highmark Wholecare or Highmark Senior Health Company. PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield or Highmark BCBSD Health Options Inc. d/b/a Highmark Health Options. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company, or Highmark Senior Solutions Company or Highmark Health Options West Virginia Inc. d/b/a Highmark Health Options. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.