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Starting January 28, 2022, FSBP will offer direct coverage – meaning no up-front, out-of-pocket costs for you, the member – through our partnership with ESI. There are two options to take advantage of direct coverage: through Express Scripts Home Delivery pharmacy or at Express Scripts network retail pharmacy locations.
To order from the Express Scripts Home Delivery pharmacy, log into Express-Scripts.com and click on the link for the “COVID-19 Resource Center.” You will find a link to place an order in that Resource Center. You also can call 800-818-6717 and a Patient Care Advocate can assist you. Please note that supplies of OTC testing kits are low. The pharmacy will hold member orders until supplies are available.
You also can take advantage of the direct coverage option at any Express Scripts network retail pharmacy locations. You can find nearby network pharmacies at www.express-scripts.com/fsbp, click on “Locate A Pharmacy.” At this time, only the tests listed in the chart at the end of this email are included in the program. To take advantage of this option, select the test kit you wish to purchase and take it to the pharmacy counter. Present your FSBP ID card. The pharmacist staff will collect the necessary information and file a claim with the Plan for the cost of the tests. Direct coverage is only available when presenting your card at the pharmacy counter, not at the regular checkout lanes.
FSBP strongly recommends that you utilize the ESI program options whenever possible to purchase OTC COVID-19 tests. This program helps you avoid out-of-pocket costs and eliminate time spent filing claims.
Stateside members may wish to purchase other tests or tests from other retailers. In those cases, you will still pay for the test at the time of purchase and file a claim with the Plan. We recommend you submit claims through our online Member Portal using the “Claims for COVID-19 Over-The-Counter Testing Kits” submission option. Beginning February 1, 2022, the Plan will reimburse only $12 per test procured outside the ESI program. This is in keeping with the Federal guidance issued on January 10, 2022.
Please note: FSBP and ESI do not guarantee availability of OTC COVID-19 tests at any of these retail locations.
Overseas members receive 100% coverage for the cost of OTC COVID-19 tests approved by local health authorities and purchased at overseas retail locations. If you are overseas and purchase tests from a US-based retailer, then the stateside coverage rules outlined above will apply.
Please note: the Express Scripts Home Delivery pharmacy can ship to APO, FPO, and DPO addresses.
For members outside the US, FSBP will cover locally-approved OTC COVID-19 tests purchased at overseas locations at 100%.
In the U.S., all FDA-approved OTC COVID-19 tests are approved for US-based members. However, only a limited number of tests are included in the Express Scripts program.
GENERIC DRUG NME
PACKAGE SIZE QTY
INTELISWAB COVID-19 HOME TEST
COVID-19 ANTIGEN TEST
BINAXNOW COVID-19 AG SELF TEST
QUICKVUE AT-HOME COVID-19 TEST
IHEALTH COVID-19 AG HOME TEST
ELLUME COVID-19 HOME TEST
FLOWFLEX COVID-19 AG HOME TEST
Current as of 1/28/2022
No, coverage is available in the US, only with respect to the OTC COVID-19 tests, without an order or individualized clinical assessment from a health care provider. When obtaining tests through the ESI program,
For overseas requirements, please refer to local health authorities.
Yes. FSBP will cover a maximum of eight (8) tests per covered member per rolling 30 days regardless of where the tests are purchased. This limit applies to enrollees as well as covered dependents. The limit applies to individual tests. If you purchase a multi-pack, each test in the pack counts towards the monthly limit, i.e. a 2-pack of tests counts as 2 tests.
Please submit an itemized receipt through our online Member Portal showing the date of purchase, the store or supplier from which you made the purchase, and specific listing of the type and number of tests you purchased. Include in your submission a note detailing the quantity of tests purchased for each covered family member, e.g. 2 for Martin, 2 for Brittany, 6 for Emilio.
The fastest way to submit your claim is through our online Member Portal. Please use the new “Claims for COVID-19 Over-The-Counter Testing Kits” option and include the information and documentation detailed in the previous paragraph. We also recommend you sign up for electronic funds transfer (EFT) to receive your reimbursement as quickly as possible.
You can mail claims to the Plan. Please include the requested information.
For tests purchased through the ESI program, the Plan pays 100% of the cost.
For tests purchased outside the ESI program from a stateside supplier, the Plan will reimburse a maximum of $12 per test.
For tests purchased by members outside the US from overseas suppliers, the Plan will reimburse 100% of the cost of the test.
The Plan forwards all claims with member responsibility to FSAFeds. Please visit www.fsafeds.com for information on how that program is handling OTC COVID-19 tests.
Beginning on April 4, 2022, Medicare Part B began coverage of OTC COVID-19 tests. You can obtain up to 8 tests per month at no cost to you until the end of the public health emergency. You must obtain tests at participating pharmacies. You can find the full details for the program, including a partial list of participating pharmacies, by visiting the Medicare Coronavirus website.
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