At-home COVID-19 Tests

Effective January 15, 2022, your Benefit Fund will cover up to eight (8) FDA-approved over-the-counter (OTC) COVID-19 rapid home tests per eligible* member every 30 days, per CMS guidelines.

OTC COVID-19 tests are covered through your prescription benefits but you do not need a prescription from a doctor.

There are three ways you can get your OTC COVID-19 tests:

No-cost Pharmacy Option

For your convenience, you may visit your local retail pharmacy and follow these steps to obtain OTC COVID-19 tests at no cost to you through the Express Scripts COVID-19 Over-the-Counter Test Network Solution:

  • Call your local retail pharmacy to see if they have at-home FDA-approved COVID-19 tests available and confirm that a pharmacist will be on duty when you wish to pick up your tests.
  • Take your 1199SEIU Health Benefits ID card to the retail pharmacy.
  • Bring the COVID-19 tests to the pharmacy counter, not the regular checkout lane.
  • Check out at the pharmacy counter and show your 1199SEIU Health Benefits ID card, the same way you would pick up a prescription. Your at-home COVID-19 tests should automatically ring up at no cost to you.

Note: Due to inventory shortages, you may be limited to requesting 4 COVID-19 tests per day.

No-cost Direct Mail Order Option

When you order COVID-19 test kits through the mail, the shipping time may be up to two weeks. If you are experiencing COVID-19 symptoms, you should take advantage of immediate testing options, like your local pharmacy or testing clinic.

You can order OTC COVID-19 tests directly from Express Scripts, to be delivered by mail to your home address. Please visit Express Scripts’ COVID-19 Resource Center to order tests online by clicking the Order At-home COVID-19 Tests link at the bottom of the page, or call 1-800-818-6720 to request your tests. Note: Due to inventory shortages, you may be limited to requesting one COVID-19 test kit per order and may experience delayed delivery.

Claim Reimbursement Options

If you paid out-of-pocket to purchase your OTC COVID-19 tests, you may submit a claim reimbursement for the purchase price up to $12 per test.

If you are seeking reimbursement for tests purchased, please submit requests to Express Scripts by mail or fax. To submit a request, complete the first page of the Prescription Drug Reimbursement Form, and send it along with your test purchase receipt to the address or fax number on the form.

Please make sure you choose an FDA-approved test brand. Some examples are:

  • Abbott BinaxNOW COVID-19 Antigen Self-Test
  • On/Go COVID-19 Antigen Self-Test
  • Quidel QuickVue At-Home OTC COVID-19 Test

See the FDA website for a complete list of approved tests.

Please note that we cannot reimburse claims for OTC COVID-19 tests purchased before January 15, 2022. Tests purchased for your personal use between January 15, 2022, and January 31, 2022, will be reimbursed at the full purchase price.

*Eligible members include NBF Wage Class I and II members, including early retirees; GNY Eligibility Class I and II members; GNY-NJ Eligibility Class I, II and III members; Home Care Benefit Fund members; and NBF-Rochester members.