How to get reimbursed for COVID-19 tests

You can be reimbursed (paid back) for both:

• Over the counter (OTC) at-home tests
• Laboratory tests
   

Medi-Cal members: Do NOT use this page for test reimbursement. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. Visit the Medi-Cal website for more details. Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers.

Over the counter (OTC) at-home tests

Reimbursement is limited to OTC COVID-19 at-home tests authorized for emergency use by the Food and Drug Administration. Coverage varies by plan type. Each test within a package is counted individually. For example, one box containing two tests counts as two tests.

Reimbursement guidelines

All OTC at-home tests ordered by a healthcare provider are covered. If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. This currently does not apply to Medicare Advantage members.  

Medicare Advantage members: You will need an order for an OTC at-home test from an authorized healthcare provider to get reimbursed at this time. 

Online claims
When filing claims online, you must use a separate claim form for each receipt and for each member. (To submit a single form for multiple members and/or receipts, use a mail-in form instead. See below.)

Online claim example 1: Let’s say you made a one-time purchase of up to 24 tests for three members. In this case, you should fill out three claim forms – one for each member. With each claim form, you should include the same receipt.

Online claim example 2: If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. 

Mail-in claims
Mail-in claim forms allow you to submit a claim for multiple members with one form. You can also include multiple receipts with one form.

Medicare Advantage members: Use the claims form for OTC at-home tests with a healthcare provider order.

If you purchased an OTC at-home test at the direction of your health care provider, please use this form:

If you purchased an OTC at-home test for any other reason, please use this form:

Send a copy of all your receipt(s) with the form. If you need more space to include additional members, receipts, or healthcare providers, you may use a separate sheet of paper. However, you must include all required information requested in the form.

Mail your completed claim form with a copy of your receipt(s) to:

Blue Shield of California
PO Box 272540
Chico, CA 95927-2540

COVID-19 laboratory tests (PCR tests)

If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim.

1. Log in to blueshieldca.com (Engagement Point users at engagementpoint.com)
   
2. Choose “Claims”
3. Select “File a claim”
4. Locate on your invoice:
   • healthcare provider’s Tax ID
   • procedure code
   • diagnosis code
5. Enter that information as indicated. If any information is missing from the invoice, contact the provider
   

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