Starting on January 15th, 2022, under guidance of the Biden administration, members are now eligible for at-home over-the-counter (OTC) COVID-19 tests. As described in more detail below, OTC COVID-19 tests can be (1) obtained at no cost through retail pharmacies and health centers approved by VHP, and (2) purchased by you through pharmacies, stores, or online retailers, with your cost reimbursed by VHP after you submit a claim for reimbursement.
Below are the steps each member should take to receive zero out-of-pocket cost OTC COVID-19 tests, or to request reimbursement for approved OTC COVID-19 tests. We encourage members to take advantage of our zero out-of-pocket cost OTC COVID-19 tests available through approved retail pharmacies and approved Health Centers, as this option does not require members to submit claims for reimbursement.
Note: You are entitled to eight (8) individual OTC COVID-19 tests per 30-day period under this federal program. Additional tests are only payable by VHP if they are ordered by a Provider.
Zero Out-of-Pocket Cost OTC COVID-19 Tests:
There are two ways of receiving an OTC COVID-19 test without having to pay out-of-pocket costs up front.
Option 1: Visit Approved In-Network Retail Pharmacies
1. Check the VHP Pharmacy List to find an In-Network retail pharmacy and to contact them for availability of OTC COVID-19 tests.
2. If in stock, and after finding the OTC COVID-19 test at the in-network retail pharmacy, ask the pharmacist to process the purchase of the test through Navitus, VHP’s pharmacy benefit administrator.
3. If the in-network retail pharmacy is out of at-home tests, see if they are available at approved health centers by following the procedure below.
4. If you need help, or if in-network retail pharmacies are out of stock, please contact Member Services.
Option 2: Visit Approved Health Centers
1. Locate qualified health centers near you to pick up a zero out-of-pocket cost OTC COVID-19 test.
2. Once you locate a nearby approved health center, please check availability of the test. If available, please pick up your test.
3. If approved health centers are out of stock, please review the information under “Visit Approved In-Network Retail Pharmacies.” You can also look at the information under the “Direct Member Reimbursement Options” for reimbursement options for tests purchased from another pharmacy, store, or online retailer.
4. If you need help, or if approved health centers are out of stock, please contact Member Services.
Both of VHP’s Direct-to-Member partners will send at least eight (8) tests per shipment. Because of this, you will not be eligible for reimbursement on any more tests for that month since you will have reached the eight test/month limit. Because of the way that tests are bunded, the Direct-to-Member partner may send you more than eight tests at time. For example, a partner may only provide bundles of ten tests, and will provide you with ten tests even if you request eight tests. Please be assured that you will not be responsible for the costs of additional tests that the Direct-to-Member partner bundles in excess of your request for eight tests. Please note that due to inventory changes, tests may not always be in stock, or our partners may change quantity limits per order.
To order by phone, call Costco Pharmacy Member Services: 1.800.607.6861
Language Assistance: 1.800.752.6096
To order online:
- Visit: https://www.costco.com/home-delivery
- Select: Mail Order
- Register for a new account. You do not need to be a Costco member to use their mail order service.
- Select: Fill New Prescription
- Select: My Doctor will Call or Fax. I do not have a written prescription.
- In the Physician Info Fields:
- Enter Physicians Name: Costco Test
- Enter Physicians Phone: -
- Enter Physician City: -
- Enter Physician State: CA
- Enter Drug Information: COVID Tests
Valley Medical Center (VMC) Pharmacies
Tests may be obtained from VMC pharmacies only by picking them up in person at VMC pharmacy locations.
Direct Member Reimbursement of OTC COVID-19 Tests
If you purchase an OTC COVID-19 test and request reimbursement, please review and follow this process prior to your purchase:
1. Confirm the test is an FDA approved OTC COVID-19 test included on the list of tests authorized by the FDA.
2. If you purchased an approved OTC COVID-19 test on or after January 15, 2022, please fill out the reimbursement form provided here: https://www.valleyhealthplan.org/sites/g/files/exjcpb771/files/Direct-Member-Reimbursement-Claim-Form.pdf. Please note that although this form is titled “Prescription Drug Claim Form,” it is the correct form you should use to seek reimbursement for OTC COVID-19 tests.
3. If your reimbursement claim is approved, your purchase cost will be reviewed for reimbursement according to federal requirements, up to a limit of eight individual OTC COVID-19 tests for every 30-day period effective January 15th, 2022.
For other questions about zero-cost or reimbursed OTC COVID-19 tests, please contact Member Services at 1.888.421.8444 or by emailing [email protected].