12/22/2021
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Posted by Provider Relations
Effective December 13, 2021, Fidelis Care will cover COVID-19 “at home” tests with no member cost sharing.
Coverage will be provided for Over-the-Counter (OTC) FDA-authorized COVID-19 test kits that are used in accordance with the Centers for Disease Control and Prevention (CDC) recommendations, for antigen detection. This policy applies to both Medicaid fee for service (FFS) and Medicaid Managed Care (MMC).
To qualify, the following criteria must be met:
- Covered “at home” test kits must be authorized by the FDA for use in both symptomatic and asymptomatic patients and allow for self-collection without medical observation.
- A fiscal order by a Medicaid-enrolled practitioner for OTC tests (which includes all the same information contained on a prescription) is required.
- One test kit per fiscal order (each kit may contain two tests for serial testing), with no refills, can be ordered with a limit of one test kit per week.
If you have any questions, please call Fidelis Care Provider Relations at 1-888-FIDELIS (1-888-343-3547); TTY: 711.