See the details below to understand if and when at-home, rapid tests are covered by your plan. At a minimum, covered at-home, rapid tests must be purchased over the counter and authorized by the FDA. Many brands sell test kits with more than one test in it.
EmblemHealth Commercial members: As of January 15, 2022, EmblemHealth plans covers eight (8) diagnostic only COVID-19 at-home, rapid tests per member per month, as long as the test is not for employment or other non-covered purposes, such as for return to work.
EmblemHealth Essential Plan members: As of January 3, 2022, EmblemHealth covers two (2) COVID-19 at-home, rapid test kits per week with no out-of-pocket costs. Test kits may include more than one test.
EmblemHealth Medicaid and HARP members: As of February 8, 2022, EmblemHealth covers up to eight (8) COVID-19 at-home rapid tests per month with no out-of-pocket costs. As of January 10, 2022, an order from a provider is no longer required for such coverage. Additional tests may be covered with an order, when medically necessary. You can find a pharmacy in our network here.
EmblemHealth Child Health Plus members: As of January 27, 2022, EmblemHealth covers two (2) COVID-19 at-home, rapid test kits per week with no out-of-pocket costs. Test kits may include more than one test.
EmblemHealth Medicare Members: All Original Medicare and Medicare Advantage members who have Medicare Part B are now covered for FDA-authorized over the counter COVID-19 at-home rapid test kits. Beginning April 4, 2022, Medicare will cover up to eight (8) tests per calendar month in Medicare participating pharmacies with no out of pocket costs. You can visit a Medicare participating pharmacy and show your red, white, and blue Medicare card to receive your tests. Go to the pharmacy website or call the relevant pharmacy listed for details on participating locations and how to order. Visit Medicare’s website for more information.