UPMC Health Plan to reimburse commercial members for eligible COVID-19 tests
UPMC Health Plan is providing reimbursement for COVID-19 tests for members covered by employer plans, including fully insured, self-funded and individual plans, in accordance with recent federal requirements.
The Biden administration issued guidance requiring commercial insurers and group health plans to cover the cost of over-the-counter (OTC) COVID-19 tests effective Saturday, Jan. 15, 2022. The coverage is for up to eight FDA-authorized OTC tests per month per covered individual. The tests must be purchased through a pharmacy, retail store, or retailer website. Both OTC and laboratory tests that are ordered or administered by a health care provider after an individualized clinical assessment - including for those who may need them because of underlying medical conditions - will continue to be covered for our members.
As noted in the federal guidance, coverage does not apply to tests used for workforce or other forms of surveillance testing.
Please use the links below to access important information about the reimbursement application process:
If you have any questions about the reimbursement process, please contact your UPMC Health Plan representative.
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