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Effective January 15, 2022, an expansion of the Affordable Care Act – Families First Coronavirus Response Act - requires group health coverage plans to allow for coverage for Over the Counter (OTC) testing to detect SARS-CoV-2 and/or to diagnose COVID-19.
Under the requirements, OTC tests are to be provided with:
Eight (8) tests per month, per covered individual.
Medicare (Part B) now covers up to 8 over-the-counter COVID-19 tests each calendar month, at no cost to you (see Endowed Retiree section below for more detail).
In addition to the group health insurance coverage noted below, every residential household in the U.S. is able to receive four (4) at-home Covid-19 OTC tests at no cost.
Order Free At-Home Tests now as shipping typically takes 7-12 days.
The details below are our understanding of how the reimbursement will be processed under Cornell’s various plans. This could change, as additional information is provided and the requirements are clarified. Cornell will continue to monitor changes over the next days and weeks, as processes with each vendor are confirmed and finalized. Please return to this page frequently and we will note when the information has been updated. In the case of a discrepancy between this summary and the official Plan Document(s), the Plan Document(s) will take precedence.
Updated as of 05/31/2022
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from OptumRx.
*Members are limited to 8 tests (4 kits) per household per calendar month at the Optum Store. To access additional supply for dependents, please visit a network pharmacy or retailer and submit a claim for reimbursement.
The FSA or HSA should only be used to reimburse expenses after claims have been processed through insurance.
Members who pay for test kits must submit claims to insurance first, then submit to Payflex FSA or HSA for the difference (if any). For example, a test kit that cost $20 and insurance covers $12, you can submit the $8 difference under your FSA.
Updated as of 02/15/2022
OTC diagnostic tests are covered with no out-of-pocket cost at participating network pharmacies using your Empire Plan, Excelsior, or SEHP ID Card.
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from MVP HMO.
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from HMO-BLUE.
Members who purchase an at-home COVID-19 test can submit a paper claim for reimbursement.
Please follow these steps:
In the future, tests may be available from in-network pharmacies – with no co-payment and no claim forms (more information to follow).
The FSA should only be used to reimburse expenses after claims have been processed through insurance.
Members who pay for test kits must submit claims to insurance first, then submit to Payflex for the difference (if any). For example, a test kit that cost $20 and insurance covers $12, you can submit the $8 difference under your FSA.
PayFlex will apply the limit to their reimbursement, i.e., eight (8) tests per month, per covered individual.
Updated as of 05/31/2022
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from OptumRx.
*Members are limited to 8 tests (4 kits) per household per calendar month at the Optum Store. To access additional supply for dependents, please visit a network pharmacy or retailer and submit a claim for reimbursement.
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) will be eligible for reimbursement from the Aetna RPHP plan
Forms and additional information is available through the Aetna Retiree Service Center: Aetna Retiree Service Center, 1-800-338-4533, (TTY: 711), Monday – Friday, 8 a.m. to 8 p.m. ET
Individuals enrolled in Medicare Part B can get up to eight free over-the-counter tests per month during the COVID-19 public health emergency.
A partial list of participating pharmacies can be found at https://www.medicare.gov/covid-19-tests-participating-pharmacies.
You should bring your red, white, and blue Medicare card to a participating pharmacy to get your free tests.
Please review the OptumRx information to access additional coverage for OTC Covid-19 self-test kits.
Individuals enrolled in Medicare Part B can get up to eight free over-the-counter tests per month during the COVID-19 public health emergency (PHE). If you are in a Medicare Advantage plan, the tests covered under the PHE initiative will be covered through traditional Medicare Part B, not your MA plan.
A partial list of participating pharmacies can be found at https://www.medicare.gov/covid-19-tests-participating-pharmacies
You should bring your red, white, and blue Medicare ID card to a participating pharmacy to get your free tests (even if you have a Medicare Advantage Plan).
For additional information, contact the Aetna Retiree Service Center: Aetna Retiree Service Center, 1-800-338-4533, (TTY: 711), Monday – Friday, 8 a.m. to 8 p.m. ET