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endstream endobj 468 0 obj <>/ProcSet[/PDF]>>>>stream Highmark Blue Cross Blue Shield of Western New York is closely monitoring the COVID-19 (Coronavirus) situation. You can also submit reimbursement for home test kits. If youre visiting the governments home test kit site without using the link above, please make sure you are on the correct page by looking for the U.S. flag in the top left corner and text that states An official website of the United States government.. H0148_22_003_C_020822. FDA-approved tests are covered for $0 when received at a pharmacy or healthcare provider participating with the federal government. Then, complete and submit the online form. For more information, view our privacy policy. UnitedHealthcare COVID At-Home Test Reimbursement Form. All information below is required. The policy only covers over-the-counter Covid-19 tests authorized and approved by the U.S. Food and Drug Administration (FDA). The protection of your privacy will be governed by the privacy policy of that site. Please note that taxes and other fees are not eligible for reimbursement. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream D@3[0V Over-the-Counter Tests | CareFirst BlueCross BlueShield follow the latest CDC guidance for isolation. Wu3B= e&gZ-h'BR$djC?Wn>2esFdUb'$K6Q Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. This coverage began on January 15, 2022. Once we process your claim, the contract holder will receive a reimbursement check by mail. Online claim example 2: If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. The Formulary Exception process allows members to apply for coverage of a non-covered drug if they have tried and failed the covered drug (s). Mail-in claim forms allow you to submit a claim for multiple members with one form.