Coverage for COVID-19 tests

Through Dec. 31, 2024, CORE, UC Care and UC Health Savings Plan will continue to cover at-home over-the-counter antigen tests and cover PCR testing if ordered by a physician at the applicable laboratory plan benefits. 

Please note that the Anthem and Navitus public websites list the end date of coverage for over-the-counter COVID-19 antigen tests as December 31, 2023. This information does not apply to UC medical plan members. Requirements for the coverage of COVID-19 tests have changed for some medical plans but not for others, depending on state laws and the type of plan. 

To receive reimbursement for over-the-counter COVID-19 antigen tests, members must mail a member claim form PDF along with the receipts for the over-the-counter COVID-19 antigen tests to the Anthem Claims Address: PO Box 60007, Los Angeles, CA 90060-0007. Members only need to complete Section 1 and Section 2 of the claim along with their signature. Do not submit OTC COVID test claims through the member portal or the Sydney mobile app.

In-network — At-home COVID-19 antigen tests are covered at no cost, but members may need to pay upfront and file a claim for reimbursement. PCR COVID-19 tests continue to be covered at $0 cost-share.

Out-of-network — Members need to pay upfront for at-home COVID-19 antigen tests and file a claim for reimbursement for up to half of the cost or a maximum of $12 per test, whichever is less. PCR COVID-19 tests are subject to applicable cost sharing unless delivered as part of covered urgent or emergency care.

Visit kp.org/covid for more information.  

In-network: COVID-19 at-home over-the-counter antigen tests are available at no cost at in-network retail pharmacies, with a maximum of eight tests per member in a 30-day period. COVID-19 diagnostic/antibody PCR tests, vaccines and therapeutics are covered at no cost, with no prior approval required.  

Out-of-network: Effective January 1, 2025, UC Blue and Gold HMO will change its coverage for out-of-network COVID-19 tests, vaccines, and therapeutics to 50% coinsurance, from no cost in 2024.

Members need to pay out-of-pocket for over-the-counter (OTC) antigen COVID-19 tests that are purchased out-of-network and submit a medical claim form for reimbursement. The tests are limited to eight per member in a 30-day period, and the reimbursement is capped at $12 per test, including tax and shipping costs.

Visit Health Net on COVID-19 tests for more information.