COVID-19 testing and coverage

Free COVID-19 Testing

There are several federal and state programs for free COVID-19 testing.

You can order free at-home rapid COVID-19 tests from the federal government. Visit www.covidtests.gov for details and to place your order.

Visit covidtests.gov

Free at-home rapid tests may also be available at community health centers and Medicare-certified rural health clinics. Find a health center.

There are state and local programs in place for free COVID-19 testing, as well. In addition to the state resources listed here, look to your local board of health or your city or town website for more information.

Over-the-counter, at-home COVID-19 tests

We are covering the cost of up to eight over-the-counter, at-home COVID-19 tests per member, per month as further described below. We will pay only for tests that are approved by or granted emergency use authorization by the FDA, are intended for individualized diagnosis or treatment of COVID-19 (not for resale) and are not for employment purposes. View a list of eligible tests.

Commercial HMO, PPO or POS members

  • Commercial HMO, PPO or POS members can visit the following pharmacies and purchase the tests with no upfront cost:
    • Rite Aid
    • Walmart
    • Sam’s Club
    • Walgreens
    • Kinney Drugs
  • Commercial HMO, PPO or POS members paying for at-home tests out-of-pocket can also submit a form for reimbursement through OptumRx, our pharmacy benefit manager. Members can submit an online reimbursement form, or they can complete a paper reimbursement form and mail it with their receipts to OptumRx. Please see the forms for instructions.
  • We will only pay for eligible tests that are not resellers and are purchased on or after January 15, 2022. (Examples of resellers that are ineligible for reimbursement include Ebay, Craigslist, OfferUp, Shopify, Facebook Marketplace and Bonanza).
  • Please note, self-insured employer groups may choose to administer this benefit through their pharmacy benefit manager. Members of self-insured groups should follow up with their employer to confirm their coverage options.

Medicare Advantage StrideSM HMO and HMO-POS members

There are two additional ways to get over-the-counter COVID-19 tests at no cost to you. We encourage you to take advantage of the Medicare coverage first, before using your Harvard Pilgrim Health Care Medicare Advantage StrideSM HMO/HMO-POS coverage. Coverage details are listed below:

1. Medicare coverage for at-home tests

As of April 4, 2022, Medicare covers up to eight over-the-counter COVID-19 tests each calendar month, at no cost. This coverage continues until the end of the COVID-19 public health emergency (PHE), and is available to anyone with Medicare Part B, including those enrolled in a Medicare Advantage plan. The tests covered under this initiative are in addition to the over-the-counter tests covered by Harvard Pilgrim Health Care StrideSM Medicare Advantage HMO.

You can get the Medicare-covered, over-the-counter COVID-19 tests at any pharmacy or health care provider that participates in this initiative. Just show your red, white, and blue Medicare card to get your free tests.

See a list of participating pharmacies
Get more information on Medicare coverage for at-home-tests

4. Medicare Advantage StrideSM HMO and HMO-POS coverage for at-home COVID-19 tests

Prior to the announcement of Medicare coverage, Harvard Pilgrim Health Care Medicare Advantage StrideSM HMO and HMO-POS made the decision to provide coverage for over-the-counter, FDA-approved or Emergency Use Authorized (EUA) antigen & molecular, at-home COVID-19 tests. We are continuing this coverage in addition to the Medicare coverage. We encourage you to take advantage of the Medicare coverage by showing your red, white, and blue Medicare card at the pharmacy. If the pharmacy is not a participating pharmacy for the Medicare coverage, show your Harvard Pilgrim Health Care StrideSM Medicare Advantage ID card. Your coverage details through Harvard Pilgrim Health Care are as follows:

  • Harvard Pilgrim Health Care Medicare Advantage StrideSM HMO and HMO-POS plans will provide coverage for up to eight over-the-counter at-home COVID-19 tests per member, per 30 days.
  • Coverage applies to tests that are approved by or granted Emergency Use Authorization (EUA) by the FDA and are intended for individualized diagnosis or treatment of COVID-19 (not for resale).
  • Coverage applies to eligible tests that are purchased on or after February 1, 2022, through December 31, 2022.
  • As of February 15, 2022, you are covered to purchase the tests with no upfront, out-of-pocket cost at participating in-network pharmacies. Search for an in-network pharmacy near you.
  • If you purchase eligible at-home tests out-of-pocket on or after February 1, 2022, you can submit for reimbursement. Print your Reimbursement Form or request one from Member Services and mail it to us with copies of your receipts. Copies of your receipts are required for reimbursement. The form includes further instructions on how to submit for reimbursement.
  • You also have the option to submit for reimbursement online. If you purchased tests on or after February 15, 2022, you can submit for reimbursement directly through OptumRx. Just fill out the form at this link and upload a photo of your receipt.
  • Tests purchased through resellers (e.g., eBay, Facebook Marketplace) are not eligible for reimbursement.
  • Most reimbursement requests are processed within 60 calendar days.
  • Reimbursement requests must be received by Harvard Pilgrim Health Care by March 31, 2023.
  • Taxes, shipping, and handling are not eligible for reimbursement

Medicare Supplement and Medicare Enhance members

If you purchase your own Medicare Supplement policy, or if you have a Medicare Enhance plan through your employer, you are covered for over-the-counter COVID-19 tests through Medicare and can visit a participating Medicare pharmacy location to purchase tests with no upfront cost. Medicare will cover the cost of up to eight over-the-counter COVID-19 tests per month at participating locations. Visit www.medicare.gov for complete coverage information.

In-person PCR, antigen and antibody laboratory tests

We also cover in-person PCR (polymerase chain reaction), antigen and antibody laboratory testing consistent with federal and state guidance at no cost to our members. These tests must be medically necessary, as determined by a health care provider, in accordance with current CDC and state public health department guidelines.

COVID-19 PCR tests that are laboratory processed and either conducted in person or at home must be ordered or referred by a provider to be covered benefits. We will not cover or reimburse you for these tests when you order them yourself, including when you order using an online self-completed questionnaire. Testing is not covered solely for general workplace health and safety, public health surveillance or for other purposes not primarily intended for a member’s individual COVID-19 diagnosis or treatment. Diagnostic coronavirus testing required as a condition of travel inside or outside of the United States is not covered.

Diagnostic testing required by your provider for surgical or other medical procedures is medically necessary and covered, including if you are pregnant or an expectant parent and testing is required prior to admittance to a delivery facility.  As always, coverage is only available to health plan members.

Updates to our current COVID-19 testing policies will be published to this site as they become available.

Last Update: 05/10/2022