To: ELIGIBLE MEMBERS OF THE MASONRY WELFARE TRUST
How Can I get My At-Home Over-the-Counter COVID-19 Test for Free Starting January 15, 2022?
If you have medical coverage under the Masonry Welfare Trust and go to a participating pharmacy, you can get at-home over-the-counter COVID tests (OTC Test) purchased on January 15, 2022 and after, without any upfront cost to you and without a prescription or physician’s order. Please read the information below to see how it works.
When does this start?
This starts with OTC Tests purchased on January 15, 2022 or later. OTC Tests that you bought prior to that date are not eligible for reimbursement.
Will I have to pay for my test up front?
If you use your prescription drug card to obtain the eligible OTC Test at a participating pharmacy, you pay nothing.
Please be sure you are using the new prescription card that was mailed out at the end of December. The front of your card will say Moda, and on the lower right side of the back, it will say Navitus. If you still have the old card with MedImpact, please shred it. It will no longer work.
If I pay up-front, how do I get reimbursed?
If you are charged for your test, you will be able to submit a claim for Direct Member Reimbursement (DMR). Please keep the original receipt and the actual UPC/barcode from the packaging of the OTC Test. More information will be coming later describing how to submit a DMR claim. The Plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Save your receipt(s) and packing to submit for reimbursement.
How many tests can I get?
The Plan is required to provide payment for up to 8 tests per month for each covered individual on the Plan, regardless of whether the tests are bought all at once or at separate times throughout the month. That means a family of four can get 32 tests per month for free. Note that tests may be packaged individually or with multiple tests in one package (for example, two tests packaged in one box). The Plan will cover 8 tests per covered individual per month, regardless of how they are packaged and distributed. There is generally no limit on the number of COVID-19 diagnostic tests, including at-home tests, that must be covered when ordered or administered by a health care provider.
What if I lose my coverage or can’t afford to pay for the at-home over-the-counter COVID-19 test(s) upfront?
You can also access free testing in the community. A list of community-based testing sites can be found at www.hhs.gov/coronavirus/community-based-testing-sites. COVID-19 tests are also available without cost[1]sharing to covered individuals when administered by a health care provider like a nurse, doctor, or pharmacist, without limitation.
The Biden-Harris Administration is purchasing 500 million OTC Tests to be distributed for free to all Americans who want them, with the initial delivery starting in January 2022. There will be a website where Americans can request at-home tests for home delivery—for free. More information on this federal program is expected soon.
People without insurance can also get free at-home test from some community health centers. In addition, the U.S. Department of Health and Human Services (HHS) is providing up to 50 million free, at[1]home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. The program is intended to ensure COVID-19 tests are made available to populations and settings in need of testing, especially populations at greatest risk from adverse outcomes related to COVID-19. As of December 21, 2021, all Health Resources and Services Administration (HRSA) - supported health centers (including look-alikes) and Medicare-certified rural health clinics are eligible to participate in the program after completing the on-boarding process. More information about this program can be found at www.cms.gov.
HHS also has established more than 10,000 free community-based pharmacy testing sites around the country. To respond to the Omicron surge, the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA) are creating surge testing sites in states across the nation. Additional information about testing resources for people without insurance are available here: https://www.hhs.gov/coronavirus/covid-19-care-uninsured-individuals/index.html
