UPMC insurance sets covid test reimbursement guidelines

UPMC Health Plan announced procedures Friday night for employers and individuals covered under UPMC insurance to get reimbursed for eligible home covid tests.

The Pittsburgh-based health insurer said that it will take requests for reimbursement by mail and also is creating an online system. The health plan, associated with UPMC’s hospital network, will provide coverage for eight tests per member, each month.

UPMC Health Plan said that those insured will not be reimbursed for any tests bought before Jan. 15.

The Biden administration is requiring private insurance companies and group health plans to cover the cost of over-the-counter at-home covid tests, beginning Saturday.

Tests that are ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions, will continue to be available.

Highmark’s plan

Highmark said it also will reimburse its members for the home covid tests bought beginning Saturday. It is looking at ways for how its members would not have to pay for the tests, then seek reimbursement.

While this mandate does not extend to Medicare members, UPMC for Life Medicare Advantage members already receive full covid testing coverage when testing is ordered by a physician.

Health plan members can contact the health plan for more information on this and other covid-related coverage.

Forms and details on the current manual submission process are available at www.upmchealthplan.com/covid and www.upmchealthplan.com/covid, where information regarding vaccines, testing, and covid news are also posted.