What do members need to do?
To ensure members pay $0 copay for at-home OTC COVID-19 tests, you simply need to:
- Take your UMR/Express Scripts ID card to a retail pharmacy in the network. Claims will be processed by Express Scripts (ESI).
- Bring an at-home COVID-19 test to the pharmacy counter, not the regular checkout lane.
- Check out at the pharmacy counter and show the UMR/Express Scripts ID card. The at-home COVID-19 tests should automatically ring up at no cost to the member.
What are the benefits to members?
Seamless experience at the point of sale: Claims for at-home OTC COVID-19 tests will automatically process at $0 copay when members order through the Express Scripts Pharmacy or check out at in-network pharmacy counters.
Predictable $0 copay: Members are eligible for up to 8 at-home COVID-19 tests at the pharmacy counter every 30 days for a $0 copay.
What if the pharmacy rejects the claim at the point of sale or a member checks out at a front-end register?
Express Scripts anticipate seamless integration at in-network retail pharmacies. However, they can process manual claims for at-home COVID-19 tests using UPC codes from any retail or online provider. Members should click here to submit manual claims for reimbursement for at-home tests purchased on or after Jan. 15, 2022.
Claims will be capped at $12 per test.
Please note that pharmacy purchase limits on at-home COVID-19 test kits may apply.
To find a retail pharmacy in your network:
Visit express-scripts.com and click “Find a Pharmacy.” You can also use their mobile app.
For more information about COVID-19, or to submit a receipt for reimbursement, visit the Express Scripts resource center at express-scripts.com/covid-19/resource-center.
Out-of-Network Covid-19 at-home Purchases:
- Save your receipt
- Save the packaging
- Paper form does not need a pharmacist signature
Federal Government Free Resource
With the help of the United States Postal Service (USPS), households can request a total of four (4) tests to be delivered for free. To learn more and order at-home test kits, visit www.covidtests.gov