Coronavirus (COVID-19) Frequently Asked Questions
At Navitus, your health and well-being are our top priorities.
Every day brings new updates about the coronavirus outbreak. We know you may have questions about your pharmacy benefits and the medications you take regularly. To help answer your questions, we have put together the following FAQs.
We will continue to closely monitor the situation, and update the FAQs as needed to provide you with the latest information.
COVID-19 General FAQs
There are currently no validated treatments for COVID-19. Please refer to the above websites.
No. Any lab testing is traditionally covered as a medical benefit, not a pharmacy benefit. Check with your health plan to see if they cover the test. You should be able to find that number on the back of your health insurance card.
As of January 15, 2022, members covered by private health insurance or a group health plan will be able to purchase OTC COVID-19 tests authorized by the U.S Food and Drug Administration (FDA) at no cost without a prescription.
The reimbursement of OTC COVID-19 tests will remain in effect until the Public Health Emergency (PHE) is rescinded. That date has not yet been announced.
You are eligible if you are covered by private health insurance or a group health plan. This includes self-insured plans.
State Medicaid and CHIP programs are required to cover FDA-authorized at-home tests. If you have Medicaid or CHIP coverage, contact your state agency, as coverage rules may vary by state.
Every covered individual can obtain eight OTC COVID-19 tests every 30 days. This limit does not apply to test kits ordered by a health care provider.
Keep in mind that pharmacies and retailers may place their own quantity limits on the purchase of tests if supplies are limited.
No. You do not need a prescription unless you are looking to be reimbursed from more than eight tests in a rolling 30-day period. Please note that it is up to the pharmacies whether they will process test kits for $0 without a prescription.
If you paid out of pocket for the test kits and want to be reimbursed:
- Confirm your plan is covering the test kits through a Navitus network pharmacy.
- If test kits are covered for you as a pharmacy benefit, you will need to submit a completed COVID-19 OTC Test Claim Form along with your dated sales receipt. You can download the form at www.navitus.com/members.
- Some tests are sold in packages containing more than one test. You will be reimbursed up to $12 per test.
To view the list of network pharmacies, visit: https://www.navitus.com/Navitus.Web/media/pdf/Navitus-Pharmacy-Network-Listing-National-and-Chains.pdf
No. DMR claims cannot be submitted through the portal at this time.
Yes. You can use FSA/HSA reimbursement for tests that are not free. You cannot use FSA/HSA reimbursement for tests that have been reimbursed by your plan.
In order to qualify, OTC COVID-19 tests must be FDA-authorized. Examples include, but are not limited to:
- BinaxNOW COVID-19 Antigen Self-Test
- CareStart COVID-19 Antigen Home Test
- Ellume COVID-19 Home Test
- Flowflex COVID-19 Antigen Home Test
- iHealth COVID-19 Antigen Rapid Test
- InteliSwab COVID-19 Rapid Test
- QuickVue At-Home OTC COVID-19 Test
The U.S. Department of Health and Human Services (HHS) is providing up to 50 million at-home tests to community health centers and Medicare-certified clinics for distribution at no cost to patients and community members. A list of community-based sites can be found here: https://www.hhs.gov/coronavirus/community-based-testing-sites/index.html.
In addition, the federal government also announced that it has purchased 500 million rapid tests and will be distributing them free for use at home in the coming weeks. These free tests are be available to order online at www.COVIDTests.gov and https://special.usps.com/testkits or by calling 1-800-232-0233 (TTY 1-888-720-7489).
COVID-19 Medications & Refills FAQs
That depends on your state regulations, prescription benefit plan and your medication(s). To determine if your plan (or medication) is eligible for a 90-day refill, visit the Navitus member portal or your employer benefit website for information.
Yes, but only if your benefit plan and the drug are eligible for mail order. You should be able to find that information on the Navitus member portal, your employee benefit website or your benefit booklet. During this event, many pharmacies are offering alternative delivery options; include curbside pick-up, home delivery, courier, and mail. Check with your local pharmacy about available options.
COVID-19 Pharmacy FAQs
Pharmacies are considered essential health care facilities and will continue to provide pharmaceutical care. Some pharmacy locations may adjust hours to accommodate staffing or local health department regulations. For updates to hours of operation and service offerings, check your pharmacy website or Facebook page for the most current information.
Please be aware that pharmacies are experiencing an unprecedented wave of people with questions about their medications. Check your pharmacy’s Facebook page or website for other contact options. Most pharmacies utilize interactive voice response (IVR) systems whereby you can initiate prescription refills or leave messages for the pharmacy staff to return your call.
Some pharmacies also support online prescription ordering processes. As a last resort, stop by the pharmacy.