COVID-19 HR Support Hub

At-home COVID-19 tests now covered by insurance under new federal requirement

A new federal policy now requires private insurers provide coverage or reimbursement for over-the-counter/at-home COVID-19 tests. Please see information below regarding this new prescription drug benefit:

• At-home COVID-19 tests purchased at participating in-network pharmacies are covered by the Washington University pharmacy benefit. Employees should present their Express Scripts member ID card when checking out. Express Scripts is in the process of automating their claims processing system so that you will not have to pay a copay at the time of purchase at an in-network pharmacy. In the interim, you will need to pay for the tests and then submit an Express Scripts Claim Form (PDF) to be reimbursed.
• The plan will cover up to eight (8) tests per member, per month. As an example, a household of one covered employee, a spouse, and two covered dependents can purchase up to 32 tests per month. If a test is sold in packaging containing more than one test, each test is counted separately (e.g., one box = 2 tests).
• Tests purchased at an out-of-network pharmacy may be submitted for reimbursement up to $12 a test. Please follow the instructions on the Express Scripts Claim Form (PDF) to submit for reimbursement.

For questions, please contact Express Scripts Customer Services at 1-877-880-1877.

Express Scripts COVID-19 medication update

If you are prescribed Pfizer’s Paxlovid or Merck’s molnupiravir, both of which are used to treat COVID-19, it is covered through Express Scripts.

Please note that this coverage is subject to the plans’ normal prescription drug copays/coinsurance provisions. Also, it is anticipated that the supply of these drugs may be limited, so Express Scripts recommends you call your desired pharmacy in advance to ensure supply.