Official State of Rhode Island website

State of Rhode Island Office of Employee Benefits

COVID Test Kit Coverage

Published on Monday, April 18, 2022

Per federal mandate, effective January 15, 2022, the RI State Employee Health Plan will provide coverage for up to eight (8) over-the-counter (“OTC” - not prescribed by a physician) at-home COVID test kits per month for each covered member (employee and dependents). As of January 28, 2022, this coverage will be available exclusively through the member’s CVS/Caremark pharmacy benefit. There will be no coverage for OTC COVID test kits under the State’s medical benefit administered by Blue Cross & Blue Shield of Rhode Island (“BCBSRI”).* Please review CVS/Caremark’s FAQ and read on for additional information and guidance.

How does this new coverage work? As of January 28, 2022, the State employee health plan’s coverage of OTC COVID test kits will be available exclusively through the CVS/Caremark pharmacy benefit. Each covered member (employee plus any dependents covered on the employee’s plan) will be eligible for coverage for up to eight (8) OTC COVID tests covered (up to $12 maximum per text kit) each month. The coverage will occur in one of two ways:

  • Point-of-sale Adjudication: The vendor that sells you the test kits may be able to process your CVS/Caremark coverage information at the point of sale so that you don’t have to spend any money out of pocket (or if the test kits cost more than $12, your coverage will reduce each kit’s cost by that amount). If point-of-sale adjudication is not available to you, please be sure to keep your receipt so that you can submit a reimbursement claim to CVS/Caremark.
  • Reimbursement: If you have to pay out of pocket for OTC COVID test kits, please be sure to save your receipts so you can submit a reimbursement claim to CVS/Caremark. Requests for reimbursement can be submitted to CVS/Caremark either through the member’s CVS/Caremark account access online through www.caremark.com or via paper claim form. For detailed guidance on how to request reimbursement from CVS/Caremark for OTC COVID test kits, please review the CVS/Caremark reimbursement guidance. Please note that any reimbursement requests submitted to BCBSRI for OTC COVID test kit purchases after January 27, 2022 will be denied.**

I purchased OTC COVID test kits between January 15, 2022 - January 27, 2022. I did not present my CVS/Caremark and/or BCBSRI ID cards when I purchased them nor did I use my State employee health plan coverage for the test kits at the point of sale. Can I get reimbursed for the cost of those test kits? Yes. Please follow the CVS/Caremark reimbursement guidance to request reimbursement of qualifying OTC COVID test kits purchased from January 15, 2022 to January 27, 2022. Please note that you will need your OTC COVID test kit receipt in order to receive reimbursement. Also, please note that any reimbursement requests submitted to BCBSRI for OTC COVID test kit purchases after January 27, 2022 will be denied.**

I purchased OTC COVID test kits prior to January 15, 2022. Can I get reimbursed for the cost of those test kits? The federal mandate does not have retroactive effect and only applies as of January 15, 2022 moving forward, so unfortunately this coverage is not available to reimburse/defray the costs of OTC COVID test kits purchased prior to January 15, 2022. However, please note that if you purchased those test kits because your doctor prescribed them, they could be covered 100% by your State employee health plan coverage (through either the medical benefit administered by BCBSRI or the pharmacy benefit administered by CVS/Caremark).

* There is 100% coverage under the RI State Employee Health Plan (through either the medical benefit administered by BCBSRI or the pharmacy benefit administered by CVS/Caremark) for at-home COVID test kits that have been prescribed by a doctor.

** If you had already sent reimbursement requests to BCBSRI in late January/early February for purchases prior to 1/28/2022, the reimbursement will be processed.