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FSBP Changes to COVID-19 Test Coverage

The Department of Health and Human Services (HHS) is planning for the Public Health Emergency (PHE) for COVID-19 to expire at the end of the day on May 11, 2023. [official HHS announcement] The declaration of the PHE on January 31, 2020, allowed the Foreign Service Benefit Plan (FSBP) to cover over-the-counter (OTC) COVID-19 tests.

Since early last year, FSBP has collaborated with Express Scripts (ESI) to offer COVID-19 tests to members at no up-front cost through retail pharmacy locations and through the ESI Home Delivery Pharmacy. This program was scheduled to conclude at the end of the PHE and as a result, will be available through May 11, 2023.

However, FSBP collaborated with ESI to resume a modified program. Beginning May 12, 2023, and in line with guidance recently issued by the Office of Personnel Management (OPM), FSBP will provide coverage for four (4) OTC tests per member per rolling 30 days. Members may purchase OTC tests and submit a claim to the Plan for reimbursement of up to $12 per test.

Starting June 1, 2023, members may resume purchasing OTC tests with no up-front costs through retail pharmacy locations or ESI Home Delivery Pharmacy – the only change is that the limit will remain at four (4) OTC tests per member per 30 rolling days. I apologize for the pause in this program for the rest of May, but it is the result of the timing of OPM guidance.

There will be no change to coverage for other COVID-19 services:

  • COVID-19 tests performed in clinical settings – e.g., doctor’s offices, urgent care centers, hospitals, lab locations, etc. – will continue to be covered at 100%. Members may be required by their provider to pay at the time of service and seek reimbursement from the Plan.
  • COVID-19 vaccines and boosters received from in-network providers and at in-network retail pharmacies will continue to be covered at 100%.
  • Other inpatient and outpatient services related to COVID-19 will continue to be covered per the terms of the 2023 FSBP Brochure.

Please refer to the Brochure for full details.

We updated our COVID-19 page with the latest guidance and coverage details. Please refer to the FAQ section if you have questions.

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