Benefits to Support You During the COVID-19 Outbreak

Who is eligible for over-the-counter (OTC) COVID-19 test reimbursement?

• Citi employees and family members covered by a Citi-sponsored health plan are eligible for reimbursement of OTC COVID-19 tests purchased without a prescription on or after January 15, 2022.
• For Aetna and Anthem members, this new coverage will be managed through your prescription drug benefit with CVS Caremark.
• For HMO members, please contact your health plan directly for guidance on how to use your at-home COVID-19 test coverage.

How many OTC COVID-19 tests are covered?

• Beginning on January 15, 2022, your prescription drug benefit will cover up to eight OTC COVID-19 tests every 30 days for each person covered under your plan. The 30-day cycle will begin when you or a covered family member first purchases an OTC COVID-19 test. For example, if you purchased a test on January 17, 2022, you will be covered for a total of eight tests per plan member between January 17 and February 15, 2022. Going forward, you and your covered family members become eligible for eight more tests per plan member between February 16 and March 17, 2022, and so on. Note that if your covered spouse and/or child each buy a test independently, their 30-day cycle(s) would begin with the date(s) they each first purchased a test.
• If you buy a package with multiple tests, each test in the package counts as a single test. If you purchase a testing kit that includes two tests, you would be limited to four kits (eight tests) per covered family member in the 30-day period.
• You do not need a prescription from your doctor to get reimbursement for your at-home COVID-19 test purchases.
• Keep in mind that if your doctor provides a prescription for you to take an at-home test, that test is covered in full and does not count toward the quantity limit of self-purchased tests discussed in this FAQ. There is no quantity limit on at-home tests prescribed by your doctor, but proof of a doctor's prescription is required for reimbursement, so make sure to submit both your COVID-19 test receipt and doctor's prescription when you file your claim.
• Be mindful that OTC COVID-19 tests are in high demand in many places and supplies may be limited.
• Some pharmacies may require that each person for whom you are buying an at-home COVID-19 test be present at the time of purchase. If that happens, your dependents may need to be present at the time of purchase to receive the allowed eight tests per covered family member every 30 days.

Can I submit an OTC COVID-19 test reimbursement claim to my Citi medical plan?

• If you’re enrolled in a Citi-sponsored Aetna or Anthem health plan, your OTC COVID-19 tests will be covered through the pharmacy benefit with CVS Caremark. You cannot submit a claim directly to Aetna or Anthem.
• If you’re enrolled in a Citi-sponsored HMO, your OTC COVID-19 tests will be covered through your medical benefit. Please contact your HMO plan for more details.
• If you’re not covered by a Citi-sponsored health plan (for example, if you’re covered by your spouse’s plan), you will need to contact your health plan directly for more details on the OTC COVID-19 test benefit.

Do I need to get a doctor’s prescription for reimbursement for an OTC COVID-19 test purchased after January 15, 2022?

• No, a prescription is not required for reimbursement of tests purchased after January 15, 2022 (up to eight tests every 30 days).
• Tests purchased before January 15, 2022, are not eligible for reimbursement unless you have a doctor’s prescription for the test.

Do I need to submit my COVID-19 test results in order to receive reimbursement?

• No, test results do not need to be submitted.

How do I get reimbursed? How long will it take?

If you pay out of pocket for your at-home COVID-19 tests, you can request reimbursement online at www.caremark.com or by submitting a paper reimbursement form. The information you will need to provide includes:

• Your mailing address (to send your reimbursement check)
• The number and type of tests you bought
• Where you bought the tests
• A copy of your receipt dated January 15, 2022, or later

You will also need to check a box indicating that you purchased the OTC COVID-19 tests for the purpose of diagnosing a possible COVD-19 infection for you or your covered family members. You will not be reimbursed for OTC COVID-19 tests purchased for employment purposes or resale, or if you are reimbursed from another source.

To submit a reimbursement request online:

• Log in to your CVS Caremark account on www.caremark.com.
• Hover over “Plan & Benefits” in the top menu and select “Submit Prescription Claim.”
• Click on “Submit at-home COVID-19 test reimbursement claim.”
• Follow the prompts to complete the claim submission process.

You’ll get a response to your request within 30 days. If your reimbursement request is approved, a check will be mailed to you.

How much can I expect to be reimbursed per OTC COVID-19 test?

• The reimbursement limit is a maximum of $12 per test, or the amount you paid for the test if it is less than $12, subject to the eight-test maximum per person, per 30 days.
• If you buy a package that contains multiple tests, the maximum reimbursement would be $12 per test. For example, a package of two tests would be reimbursed up to a maximum of $24.
• This may result in out-of-pocket expenses to you depending on what you paid for the test.

What if I purchased other items with my OTC COVID-19 test and those items appear on my receipt?

• It’s okay to submit a receipt with multiple items on it. Only the cost of the OTC COVID-19 test will be reimbursed.

Can I buy tests without having to pay anything at the time of purchase?

• Yes. If you buy an OTC COVID-19 test at a participating in-network pharmacy (CVS, Walgreens, etc.) that can bill your prescription coverage directly, there is no out-of-pocket cost to you for certain tests (as long as each test does not cost more than $12).
• For your convenience, you can use the CVS website or CVS Pharmacy app to find the nearest pharmacy that can bill your prescription coverage directly and has tests available. You will be able to confirm your coverage and place an order online. To begin, click or tap on “At-home COVID-19 tests,” and then select “Request at-home tests” under “Get tests paid for up front.”
• When your order is ready, you will receive a confirmation from CVS Pharmacy, and your order will be waiting at the front store register. (Online orders cannot be picked up at the drive-thru.)
• To purchase a test without pre-ordering online, go to the pharmacy counter where you fill prescriptions (not the front register) to have your coverage confirmed. If the pharmacy is able to bill your prescription coverage directly (not all in-network pharmacies can), you will be able to buy certain tests at no cost.
• While all FDA-approved OTC COVID-19 tests are eligible for reimbursement, only certain tests can be bought for $0 at the point of purchase using direct billing through your prescription benefit. These tests include:
• FLOWFLEX COVID-19 AG HOMETEST
• ON/GO COVID-19 ANTIGEN SELF-TEST
• BINAXNOW COVID-19 AG CARD HOME TEST
• INTELISWAB COVID-19 RAPID TEST
• QUICKVUE AT-HOME COVID-19 TEST
• Be assured that all FDA-approved OTC COVID-19 tests are eligible for reimbursement, even if they aren’t eligible for direct billing ($0 at the point of purchase).
• If you purchase a test that isn’t listed above, you will need to pay at the time of purchase and submit a claim for reimbursement afterwards. Refer to the information in the “How do I get reimbursed? How long will it take?” question above.
• Some pharmacies, including in-network pharmacies, may not have the ability to bill an OTC COVID-19 test through your prescription coverage without a doctor’s prescription. If you buy an OTC COVID-19 test at a pharmacy that is unable to bill your insurance directly or through another retailer or website, you will have to pay for the test and then request reimbursement through CVS Caremark.

Why is my pharmacy saying they can’t process OTC COVID-19 test purchases under my prescription benefit plan?

• Some pharmacies may not be able to process claims for OTC COVID-19 tests at the pharmacy counter. If this happens, you can pay for the test, then submit a request for reimbursement afterwards.
• To find a participating pharmacy and check test availability in advance, visit CVS.com or the CVS Pharmacy app.
• Click or tap on “At-home COVID-19 tests.”
• Under “Get tests paid for up front,” click on “Request at-home tests.”
• Answer “No” to the question “Are you a Medicare or Medicaid member?”
• Select the number of at-home tests you need.
• Enter your ZIP code or city and state to search for the nearest location with tests in stock.
• Select the store you want to order from.
• Log in to your CVS account or create an account to continue with your order.
• After placing your online order, you will be notified when the tests are waiting for you at the front store register. No payment will be due when you pick up your order. Your prescription coverage will be billed directly. (Online orders cannot be picked up at the drive-thru.)

I went to an in-network pharmacy and tried to purchase an at-home test with no upfront cost using my insurance but was told I needed a doctor’s prescription. What should I do?

• Certain retail pharmacies are currently in the process of updating their administrative processes to comply with new requirement to cover the cost of at-home tests without a doctor’s order.
• If you ask to have a pharmacy bill your coverage directly and are denied, you should pay out of pocket and use the claims submission process outlined in the question called “How do I get reimbursed? How long will it take?” to submit your claim.

Can I order tests through mail-order?

• CVS Caremark® Mail Service Pharmacy does not carry OTC COVID-19 tests. However, your pharmacy may offer shipping options to allow for delivery of COVID-19 tests.
• Please be advised that extra fees or delivery charges are not reimbursed, so we encourage you to obtain the tests in person.
• You can order tests online for convenient in-store pick up. Review the information in the “Why is my pharmacy saying they can’t process OTC COVID-19 test purchases under my prescription benefit plan?” question above.

Are Polymerase Chain Reaction (PCR) tests covered under an OTC COVID-19 test reimbursement claim?

• Lab-based PCR home collection kits are not covered at this time.

Note: This is a fluid situation and the information above may be subject to changes. Updates will be made when possible and appropriate.