Get $0 OTC COVID-19 test kits at your local pharmacy

You may obtain $0 over the counter (OTC) COVID-19 test kits if you purchase them from the counter of an in-network pharmacy and show your Priority Health member ID card at the point of purchase.* See details and exclusions below.

*Exception: Members whose pharmacy benefits are not administered through Priority Health.

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I have an employer-sponsored or MyPriority plan. How can i get $0 OTC COVID-19 test kits at my pharmacy

  • You may obtain $0 over the counter (OTC) COVID-19 test kits if you purchase them from the counter of an in-network pharmacy and show your Priority Health member ID card at the point of purchase.*
    • *Exception: Members whose pharmacy benefits are not administered through Priority Health.
  • This is subject to test kit availability at the pharmacy. Note: Members may purchase up to eight (8) individual (or four (4) 2-pack) kits over the counter (OTC) per covered individual within a 30-day period without a prescription from a health care professional.
  • You can use the Find a Doctor tool to find an in-network pharmacy for your plan.

I have an employer-sponsored or MyPriorty plan. Can I get reimbursed if I purchase OTC COVID-19 at-home test kits?

  • If you have a MyPriority or employer-sponsored plan with pharmacy benefits through Priority Health and you purchase an over-the-counter (OTC) COVID-19 at-home test kit from an authorized retailer, you will be eligible for reimbursement by filling out and submitting a reimbursement form* 
    • *Exception: Members whose pharmacy benefits are not administered through Priority Health.

  • Reimbursement from ESI may take up to 6-8 weeks.
  • Reimbursement will be in the form of a check mailed to the health plan subscriber even if the test kits were purchased for covered members on the plan.
  • Note: Some pharmacies may have a limited supply or may place restrictions on how many test kits you may purchase at one time.
  • Members may purchase up to eight (8) individual (or four (4) 2-pack) kits over the counter (OTC) per covered individual within a 30-day period without a prescription from a health care professional.
    • Note: COVID testing ordered by a health care professional when the test is medically necessary to diagnose and treat a patient’s symptoms continues to be covered 100%, with no member cost sharing applied and no limit to the number of tests.
  • Workplace mandated testing is not covered.

I have a Medicare plan. Can I Get reimbursed if I purchase OTC COVID-19 at-home test kits?

  • At this time, legislation from the Biden-Harris Administration applies to individuals with private health insurance coverage or those covered by a group health plan only.
  • If you’re experiencing symptoms, we recommend that you first speak to your health care provider to help you understand if you need a PCR test. Your provider will be able to assist with the scheduling process.
  • Currently, COVID-19 test coverage for Medicare members requires a lab.
    • Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional.
    • Medicare members can access one lab performed test without cost sharing per patient per year without an order.

I have a Medicaid, Children's Special Health Care Services (CSHCS), Or Healthy Michigan plan. Can I get a free OTC COVID-19 at-home test kit?

At-home COVID-19 tests for Medicaid, Children’s Special Health Care Services (CSHCS), or Healthy Michigan plan members are covered. Members may obtain free at-home tests two ways:

  • Option one: From a pharmacy according to Medicaid Policy
    • A pharmacy dispenses the COVID-19 test as a prescription.
    • The at-home COVID-19 tests you receive is Medicaid covered and approved by the Food and Drug Administration (FDA).*
    • The at-home test dispensed as a prescription is used in accordance with CDC definitions and recommendations.
    • The quantity of at-home tests dispensed as a prescription does not exceed 1 test per member per day.
    • The prescriber and dispensing pharmacy are Medicaid-enrolled.

  • Option two: If you purchase an over the counter (OTC) COVID-19 test from an authorized retailer**, you will be eligible for reimbursement if:
    • The purchase was made April 1, 2022 to present.
    • The at-home COVID-19 test purchased is Medicaid covered and approved by the Food and Drug Administration (FDA).*
    • Members may be reimbursed for up to eight (8) over the counter (OTC) tests per calendar month without a prescription from a health care professional.
    • Reimbursement will be equal to the total expense paid, up to $12.00 per test.
    • Members should fill out and submit the reimbursement form, with the UPCs (barcode on the test kit packaging) and original receipts from the authorized pharmacies or retailers as proof of purchase.
 

*Determined by MDHHS. Subject to change, a list of Medicaid-covered National Drug Codes (NDCs) applicable to the above tests is available at michigan.magellanrx.com.

**At-home COVID-19 tests are not eligible for reimbursement when purchased from a private individual via an in-person or online person-to-person sale or from a seller that uses an online auction or resale marketplace are not eligible for member reimbursement. Additionally, over-the-counter COVID-19 home tests reimbursed by another source, supplied for free to the member, or covered through the member’s pharmacy benefit plan are not eligible for DMR reimbursement by the health plan. 

At-home tests are not covered for Medicaid beneficiaries who are Medicaid-Medicare Dual Eligible (Priority Health group 10004). Dual Eligible Medicaid beneficiaries should refer to their Medicare plan for coverage.