State Health Plan members are encouraged to utilize the free COVID-19 test kits available through federal and state programs. Residential households in the U.S. can order one set of four free at-home tests from USPS.com. There is a limit of one order per residential address. One order includes four individual rapid antigen COVID-19 tests.
NC DHHS and Labcorp are teaming up to make at-home kits for COVID-19 testing available to North Carolina residents. For more information and to place an order visit the NCDHHS website.
State Health Plan Program
At-home rapid COVID-19 tests continue to be covered at 100 percent for State Health Plan members enrolled in the 80/20 and 70/30 PPO Plans as well as the High Deductible Health Plan (HDHP) via the pharmacy benefit.
However, currently many pharmacies are experiencing a high volume at the pharmacy counter coupled with staffing issues, which has led them to restricting over-the counter product processing to only those with a prescription. Therefore, many pharmacies are not accepting insurance and are requiring customers to pay in full for each test.
Members are able to submit the receipt for reimbursement by using the Prescription Reimbursement Claim form located on the Plan’s website. Members can also submit a reimbursement request online via CVS Caremark.
Members should submit a receipt that clearly indicates the test purchased, along with the claims form. Expect the claims reimbursement process to take between 30 and 90 days.
As a reminder, there is a limit of 8 at-home rapid tests per 30 days. Reimbursement does not apply to tests purchased prior to January 15, 2022.
Several retail pharmacy chains are now offering more convenient ways to order COVID-19 tests, including the ability to order them online. Check with your pharmacy for more information. Additional information is also available on the Plan’s COVID-19 webpage.