PrimeTime Health Plan will follow the Medicare mandate and pay for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, nurse practitioner, pharmacist, or other authorized health care professional. At this time Original Medicare and PrimeTime Health Plan does not reimburse for at-home tests. The U.S. Department of Health and Human Services (HHS) has established a program where individuals covered by Medicare have access to free, at-home tests.
The federal government has announced Americans will be able to request free rapid COVID-19 tests from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.
This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the 2 sets of 4 free at-home COVID-19 tests Americans can continue to order from covidtests.gov.
National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens, and Walmart.
This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:
• Requesting free over-the-counter tests for home delivery at covidtests.gov. Every home in the U.S. is eligible to order 2 sets of 4 at-home COVID-19 tests.
• Access to no-cost COVID-19 tests through health care providers at over 20,000 testing sites nationwide. A list of community-based testing sites can be found here.
• Access to lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost through Medicare.
• In addition to accessing a COVID-19 laboratory test ordered by a health care professional, people with Medicare can also access one lab-performed test without an order and cost-sharing during the public health emergency.
Will I have to pay for the Vaccine? No. The federal government purchased the vaccine and insurance companies or Medicare are required to cover the administration costs associated with the vaccine at no cost to the individual. This coverage requirement applies to almost all AultCare plans. If your plan does not cover the cost of the vaccine, there are other resources available to reimburse providers for vaccine administration. You should not be billed for this service.
Resources
• The Ohio Department of Health opened a call center to answer questions regarding COVID-19. Licensed nurses and infectious disease specialists are available to answer questions and provide accurate information about COVID-19, the risk to the public, and the state’s response. You can contact the call center at 1-833-427-5634.
• To view all communication by Governor Mike DeWine, click here.
• Click here to review important pharmacy reminders.
•Visit the Fact Sheet from CMS for detailed information
