CurrentNeighborhood Health Plan of Rhode IslandPolicy N/A

Pharmacy_No Cost At Home Covid 19 Test Kits_October 2022

Policy describes coverage of up to 8 FDA-approved over-the-counter at-home COVID-19 test kits per member every 30 days during the public health emergency; tests must be purchased in-store at participating pharmacies and presented with Neighborhood Member ID to be provided at no cost.

Policy Summary

PayerNeighborhood Health Plan of Rhode Island

PolicyPharmacy_No Cost At Home Covid 19 Test Kits_October 2022

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJan 15, 2022

Next Review Date

Key ActionPharmacies must obtain and verify the Neighborhood Member ID card from the member at purchase to provide the at-home COVID-19 test kit at no cost.

SourceLink

POLICY UPDATE CHANGES

No material changes

8Test kits allowed per 30 days

YesMember ID required at point of sale

2022-01-15Coverage start date

Coverage Summary

Policy describes coverage of up to 8 FDA-approved over-the-counter at-home COVID-19 test kits per member every 30 days during the public health emergency; tests must be purchased in-store at participating pharmacies and presented with Neighborhood Member ID to be provided at no cost.

Coverage Criteria for At-Home COVID-19 Test Kits

Covered when ALL of the following are met:

Member enrollment: Member is enrolled in a Neighborhood plan (Neighborhood member).
Timeframe: coverage applies starting January 15, 2022 and throughout the public health emergency.
Test type: Test is an over-the-counter (OTC), FDA-approved at-home COVID-19 test kit.
Place of purchase: Member purchases the kit in-store at a participating pharmacy.
Member ID at purchase: Member presents their Neighborhood Member ID card at time of purchase to receive the test kit at no cost.
Quantity limit: up to 8 test kits every 30 days per member.<= 8 per 30 days

Provider Actions and Point-of-Sale Requirements

Documentation Required

Member ID required at point of sale

Pharmacies must obtain and verify the Neighborhood Member ID card from the member at purchase to provide the at-home COVID-19 test kit at no cost.

Billing Rule

In-store purchase at participating pharmacies

Test kits must be purchased in-store at participating pharmacies to be provided at no cost; mail-order or non-participating pharmacy purchases are not covered by this policy.

Definitions & Background

Neighborhood Health Plan covers the cost of FDA-approved over-the-counter at-home COVID-19 tests for members during the public health emergency to facilitate access without prescription or cost-sharing at participating pharmacies.

Term	Definition
OTC at-home COVID-19 test kit	An over-the-counter, FDA-approved diagnostic test intended for at-home use to detect SARS-CoV-2 infection.
Participating pharmacy	A retail pharmacy that has agreed to provide no-cost at-home COVID-19 test kits to Neighborhood members upon presentation of member ID.

Frequently Asked Questions

Q: How many at-home COVID-19 test kits are covered? A: Up to 8 over-the-counter at-home COVID-19 test kits per member every 30 days.

Q: Do members need a prescription? A: No, tests are covered without a prescription.

Q: Where must members purchase the test kits? A: Members must purchase the kit in-store at a participating pharmacy and present their Neighborhood Member ID card to receive it at no cost.

Revision History

2022-01-15coverage_startLatest

Starting January 15, 2022 and throughout the public health emergency, Neighborhood covers the cost of up to 8 over-the-counter, FDA‑approved at-home COVID-19 test kits per member every 30 days, without a prescription; tests must be purchased in-store at a participating pharmacy and members must present their Neighborhood Member ID card at time of purchase to receive the kit at no cost.