Over-the-Counter (OTC) At Home COVID-19 Test Kits

COVID-19 End of Public Health Emergency Update 5.8.23

The federal government confirmed May 11, 2023 as the end of the COVID-19 Public Health Emergency (PHE). As a result, there will be some benefit changes offered through the City’s health plan through UnitedHealthcare (UHC) starting May 12, 2023 that were put in place due to the PHE.

• COVID-19 over-the-counter (OTC) tests will no longer be covered starting May 12 consistent with coverage for other over-the-counter tests. Physician ordered COVID-19 laboratory tests will remain covered and subject to the City’s health plan benefit design cost shares. Members may use FSA or HRA money to purchase OTC COVID-19 tests.
• CDC approved COVID-19 vaccines and boosters will remain a preventive benefit at no cost to the member as long as they are received from an in-network provider.
• FDA approved COVID-19 treatments, telehealth and virtual visits will remain covered and subject to the City’s health plan benefit design cost shares.

These changes were made across UnitedHealthcare’s book of business and were an expanded benefit due to the PHE. See the flyer for additional information.

Health and Pharmacy Plan Coverage for members enrolled in the City’s Health Plan Through 5.11.23

Beginning January 15, 2022, employees and family members enrolled in the City of Milwaukee's UnitedHealthcare health plan will have coverage for FDA authorized OTC at home COVID-19 diagnostic test kits purchased on or after January 15, 2022.  No prescription is required.  This at-home COVID-19 test benefit includes up to 8 tests per member per month.  The number of tests ordered will be monitored to ensure members are not exceeding the maximum allowed number of tests. 

Employees and their family members enrolled in the City's health plan have coverage for OTC COVID-19 tests through both UnitedHealthcare and Optum Rx.  Visit myuhc.com for more information about coverage through UnitedHealthcare and optumrx.com for additional information on coverage through the Optum pharmacy plan.  Members who submit a claim for reimbursement should ONLY submit the claim to either UnitedHealthcare or OptumRx never to both plans.

If employees have questions they should call the number on the back of their UHC insurance card.

How to Get OTC At Home COVID-19 Test Kits Through 5.11.23

1.  Visit an in-store pharmacy counter at a UnitedHealthcare Preferred Retailer

• Current UnitedHealthcare Preferred Retailers include Walmart Pharmacy, Sam's Club Pharmacy, Walgreens (including Duane Reade), and Rite Aid Pharmacy (including Bartell Drugs).  UnitedHealthcare is working to add additional pharmacies to their COVID-19 test kit preferred retailers program.  View the most up-to-date list of the Preferred Retailers by visiting myuhc.com.
• To use this benefit members must:
  • Purchase their OTC test kit at the preferred retailers in-store pharmacy counter
  • Show their UnitedHealthcare member id card
• Members who visit a UnitedHealthcare Preferred Retailer and purchase the OTC test kit at the in-store pharmacy counter will not have any cost and will not have to submit documentation for reimbursement.
  • Members who purchase an OTC test kit at a UHC Preferred Retailer at a checkout other than the in-store pharmacy counter can still be reimbursed, but they will need to pay for the test kit upfront and submit a receipt for reimbursement.

2.  Visit any store or online retailer

• Members who purchase an OTC COVID-19 test kit through other retailers are eligible for reimbursement up to $12 per test.
  • Many COVID-19 tests are sold as a 2-pack kit and would be reimbursed up to $24 for the 2-pack kit.
• Members can submit a receipt for reimbursement online here or can also print a form to mail in for reimbursement here.

Frequently Asked Questions - Purchasing Test Kits

1.  Is there a limit to how many tests will be covered?

Yes. Covered members can get up to 8 individual tests per month.  If the OTC test is sold as a 2-pack kit, that would count as 2 tests.

2.  What happens if I purchase OTC at-home COVID-19 tests at the front-of-store checkout of a Preferred Retailer or online instead of at the pharmacy counter?

If you purchase OTC at-home COVID-19 tests at a front-of-store checkout, you may submit your purchase receipt for reimbursement for a maximum reimbursement of $12 per test. Many OTC at-home COVID-19 tests are sold as a 2-pack, which means the test pack would be reimbursed up to $24 (up to $12 for each test).

3.  Can I purchase OTC at-home COVID-19 tests at a store that is not a Preferred Retailer?

Yes, covered members may purchase an FDA-authorized OTC at-home COVID-19 test at any in-store or online retailer. You may submit your purchase receipt for reimbursement for a maximum reimbursement of $12 per test. Many OTC at-home COVID-19 tests are sold as a 2-pack, which means the test pack would be reimbursed up to $24 (up to $12 for each test).

4.  How can I find out which Preferred Retailers have OTC at-home COVID-19 tests available?

Due to high demand, in-store associates cannot verify over the phone if COVID-19 tests are in stock.  Please be sure to check a Preferred Retailer’s website or mobile app to learn if tests are available before you visit an in-store pharmacy counter at one of the Preferred Retailers.  View the most recent list of preferred retailers on myuhc.com. UnitedHealthcare is working to continue to add more Preferred Retailers.

5.  Can I purchase an OTC at-home COVID-19 test that costs more than $12?

Yes. If you get an FDA-authorized test at an in-store pharmacy counter at a UnitedHealthcare Preferred Retailer, you won’t need to pay anything out-of-pocket. At any other location, you may purchase an FDA-authorized test, but you will only be reimbursed at a maximum of $12 per test.

6.  How many OTC at-home COVID-19 tests can be purchased at one time?

The plan will reimburse up to 8 tests every calendar month for each covered member under your plan. You may purchase up to 8 tests per covered member at one time unless other limits apply or as tests are available.

7.  Which OTC at-home COVID-19 tests are part of this program?

Any FDA-authorized or approved test is covered as part of the program. Typically, FDA-authorization is shown on the test packaging.

If employees have questions they should call the number on the back of their UHC insurance card.