January 03, 2023
A recent announcement from the federal government intends to increase access to COVID-19 testing. As of January 15, 2022, you can get reimbursed by your health plan for the costs of over-the-counter diagnostic COVID-19 tests until the end of the Coronavirus Public Health Emergency. Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed.
The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. Visit the CDC website for the most up-to-date testing guidance.
From January 15, 2022 until the end of the Coronavirus Public Health Emergency, each individual on your plan can get up to eight over-the-counter tests each month. If you purchase a test kit that includes two rapid tests, that will count as two of your eight covered tests. The federal requirement covers your cost for diagnostic tests. However, in compliance with California state law, some Anthem plans also cover COVID-19 screening tests with no out-of-pocket costs. If you’re not sure whether your plan covers COVID-19 screening, please call the Member Services number on your ID card.
You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Log in to anthem.com/ca, go to Claims & Payment, and choose Submit a Claim. You can also log in to the SydneySM Health mobile app, go to Claims, and choose Submit a Claim. If your employer has asked you to submit receipts to your pharmacy benefit plan, please don’t submit them here.
If you have an Anthem Medicaid or Medicare plan, you will need to visit your member website for information on how your health plan covers COVID-19 testing.
As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. Only visit the ER or call 911 if you’re experiencing life-threatening symptoms.
Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov.
Centers for Disease Control and Prevention website: Testing Strategies for SARS-CoV-2 (accessed January 2022): cdc.gov.
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