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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.
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.
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 02/15/2022
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from OptumRx.
*Additional pharmacies will be added to OptumRx’s network and communicated once available.
**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 02/15/2022
Tests for enrolled members (covered individual, spouse/domestic partner, dependent children) are eligible for coverage from OptumRx.
*Additional pharmacies will be added to OptumRx’s network and communicated once available.
**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
The January 10, 2022 expansion does not apply to Medicare coverage.
Please review the OptumRx information to access OTC Covid-19 self-test kits.
For the medical plan, COVID Testing will be covered as they are now, with the delivery of COVID tests ordered/administered through participating Medicare physicians and health care providers.
The January 10, 2022 expansion does not apply to the MAPD plan (or other Medicare Advantage Plans).
COVID Testing will continue to be covered as it is now, for enrolled members, with the delivery of COVID tests ordered/administered through participating Medicare physicians and health care providers.
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