Federal regulators, in response to recent direction from the White House now require coverage of over-the-counter (OTC) COVID-19 diagnostic tests even where not ordered by a healthcare provider, where the tests can be purchased without such an order.
Lockton recommends that employers ask their carrier, TPA and PBM partners (or ask your broker or consultant to ask for you) to determine the extent to which it’s possible for plan enrollees to obtain an OTC test kit at a participating retail or mail-order pharmacy without laying out any cash for it and, if an enrollee pays up front, how the enrollee submits a claim for reimbursement (e.g., can they download a claim form, can they upload a claim online, etc?).
- The list of question to ask carriers, TPAs, PBMs is here.
- Lockton’s full alert on OTC test kit coverage is here.