AS OF JANUARY 15, YOU CAN GET COVID-19 TESTS FREE AT PARTICIPATING PHARMACIES.
Individuals covered under the Fund’s active and retiree plans (excluding UHC individuals) can get up to eight (8) over-the-counter (OTC) tests per month for a $0 copay in the following ways:
- Free of charge
- By using your ESI pharmacy benefit to obtain tests at any covered retail pharmacy.
- Online through the ESI mail order pharmacy www.express-scripts.com.
- Claim reimbursement
- The Fund will reimburse up to $12 per test to eligible individuals for OTC Covid-19 tests purchased – by submitting a paper claim to the Fund’s Prescription Benefit Manager, Express Scripts (ESI) that includes the appropriate UPC number or an NDC number (national drug code).
The claim form to request reimbursement can be found at:
You can also get free tests online from the Federal government at https://www.covidtests.gov. Each household is limited to 4 free tests.
Below you will find a list of Q&As that provide the most current information on how to obtain COVID-19 tests free of charge or receive reimbursement for tests purchased.
Q1. Do I need a prescription from my doctor?
Q2. Is coverage limited?
A2. Yes. Coverage is limited to 8 tests (up to $12 each) per eligible individual within a rolling 30-day period. Each test counts as one test, even if multiple tests are sold in one package. For example, if you buy a COVID test package that includes 2 tests, you will have 6 free tests remaining. Note: This limit will not apply to coverage already in place for tests performed by providers and/or labs.
Q3. If I pay out-of-pocket at the time of purchase, how do I receive reimbursement?
A3. You must submit a paper claim and pharmacy receipt for reimbursement. If the COVID-19 Test does not process for $0 copay at the pharmacy (and you have not used your allotment of eight tests per month) do not worry. You can submit a manual claim for reimbursement for COVID-19 at-home tests purchased at a participating pharmacy on or after Jan. 15, 2022.
To submit a manual claim, please visit https://express-scripts.com/covid-19/resource-center or the BNF website to obtain the reimbursement claim form. You will need to complete the manual claims form and submit it along with a pharmacy receipt to receive reimbursement.
Q4. Where do I send my request for reimbursement?
A4. Request reimbursement for each test purchased by submitting a completed claim form with a receipt that includes the NDC (National Drug Code) or UPC (Universal Product Code) for each test purchased to the following address:
Express Scripts (ESI)
Attention: Commercial Claims
P.O. Box 14711
Lexington, KY 40512-4711
Sample UPC Code
Sample NDC Code
Q5. Do I need to purchase these tests from certain locations?
A5. No. However, to receive tests with a $0 copay at the point of sale, you must purchase tests from a participating retail pharmacy (excluding Walgreens) at the pharmacy counter or through the Express Scripts mail order pharmacy. Tests can also be purchased from other distributers such as Amazon, Target, etc. but you will be required to request reimbursement, of up to $12 per FDA approved test.
Q6. What OTC tests are covered?
A6. FDA approved tests for non-work related testing.
Q7. Are at home tests available online?
A7. Yes. Tests can also be requested online from the Express Scripts home delivery pharmacy at www.express-scripts.com.
Q8. Where can I find more information such as testing products and reliability of OTC COVID-19 test results?
A8. More information can be found online at:
To see a full description of the Plan’s benefits and limits, please refer to the 2018 Evidence of Coverage and Summary Plan Description (SPD), as amended, or for individuals covered under the Plan’s Medicare Advantage Plan, the United Healthcare Plan Guide available online at www.bnf-kc.com.