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Last updated 07/13/2022

Coronavirus FAQs: COVID-19 Testing, Vaccines & Treatment

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COVID-19 testing COVID-19 vaccines COVID-19 treatment

COVID-19 testing

  1. Will Humana cover COVID-19 testing?

    Humana covers a wide range of COVID-19 tests, including at-home, over-the-counter tests as well as tests performed in laboratories. Please read the following FAQ’s closely, as coverage may vary depending on your specific plan and the type of test.

  2. What is Humana doing to comply with the federal at-home, over-the-counter COVID-19 test kit requirement?

    Humana is committed to complying with the requirements and covering the cost of at-home, over-the-counter (“OTC”) COVID-19 test kits for our members within the limitations outlined below.

    Humana Medicare Advantage and Medicaid members:

    Beginning April 4, 2022, Centers for Medicare & Medicaid Services (CMS) announced that Medicare beneficiaries with Part B coverage, including those enrolled in Medicare Advantage, will be eligible for up to eight (8) OTC COVID-19 tests from participating pharmacies and providers each calendar month until the end of the COVID-19 public health emergency (PHE). There may be more than 1 test per box, so 8 tests may come in fewer than 8 boxes. Those with Part A-only coverage will not be eligible.

    You can get over-the-counter COVID-19 tests at any pharmacy or health care provider that participates in this initiative even if you aren’t a current customer or patient. Check with your pharmacy or health care provider to see if they are participating. If so, be prepared to share your original red, white, and blue Medicare card and they can provide your tests and bill Medicare on your behalf. A partial list of participating pharmacies can be found at https://www.medicare.gov/medicare-coronavirus. Medicare will not cover costs for over-the-counter COVID-19 tests obtained prior to April 4, 2022.

    Those with Medicaid coverage should contact their state Medicaid office for information regarding the specifics of coverage for at-home, OTC COVID-19 tests, as coverage rules may vary by state.

    Please note that the federal government has also set up a website where each family, regardless of insurance type, can get 2 sets of 4 free tests: covid.gov.

    Humana Commercial Group members (those who receive insurance through their employer):

    As announced by the U.S. Department of Health and Human Services, as of January 15, 2022, all private health insurance members are eligible to receive up to 8 at-home, OTC COVID-19 tests per 30 days (or calendar month) at no out-of-pocket cost. Eligible test kits must meet the following criteria:

    • At-home, over-the-counter, viral test kits for personal use that you are able to take and read at home without the help of a healthcare provider
    • Viral test kits that test for current infection; antibody/serology tests are not included
    • Only at-home, OTC test kits that are approved by the US Food & Drug Administration (FDA) or emergency use authorized will be covered. You can find out which tests are included by visiting the FDA At-Home OTC COVID-19 Diagnostics Test page
    • Test kits purchased for employment screening or public health surveillance purposes are not eligible for coverage
    • Please be aware that each test is counted separately even if sold in packs that contain multiple tests. For example, if you purchase a box that contains two tests, it will count as two tests toward your monthly limit of 8.

    PLEASE NOTE: Humana does not manufacture or make available these at-home, OTC COVID-19 tests for members. These tests are in high demand across the country and may be difficult to find. You may find them at local pharmacies, local stores or trusted online retailers. The federal government has also set up a website where each family can get 4 free tests: covid.gov as of January 19, 2022.

    Commercial group members have 3 options to get covered at-home, OTC COVID-19 tests for a total of 8 tests per 30 days (or calendar month):

    1. Purchase online at CVS.com using your insurance card for a $0 copay
    2. Purchase in-store at an in-network pharmacy counter for a $0 copay
    3. Pay the full amount for the test up-front at a pharmacy or another trusted retailer in-store or online and file a reimbursement claim and be reimbursed up to $12 per test

    OPTION 1: Purchase online at CVS.com:

    1. Go to the CVS.com COVID-19 test kit page
    2. Navigate to “Get tests paid for up front” and click “Request at-home tests
    3. You will be asked a series of questions to confirm your eligibility identify a store near you and select whether your tests will be picked up in-store or shipped to you
      • Note: If you are a Puerto Rico member, please only enter the first 11 digits of your member ID (without dashes)
    4. Once you select your store, you will be promoted to log in to your CVS account or create a new one
    5. Verify your information
    6. Enter the information on your Humana ID card
    7. Submit request

    OPTION 2: Purchase at-home, OTC COVID-19 test kits at an in-network pharmacy counter with your Humana ID card:

    1. Take the kit(s) to the pharmacy counter for check-out
    2. You will be asked to provide your Humana ID card
    3. The pharmacy staff will process your purchase you will owe $0 for up to 8 test kits, per member, per 30 days (or calendar month)

    Please note: If you purchase the at-home, OTC COVID-19 test kits from the retail counter, you will need to pay upfront and follow the instructions laid out in option 3. As of March 16, 2022, tests purchased at the retail counter will be reimbursed up to $12 per test.

    OPTION 3: Purchase an at-home, OTC COVID-19 test at a trusted retailer online or in-store:

    1. Purchase your test kit from a trusted retailer* and keep your itemized receipt and your test kit’s UPC code. Humana will not reimburse test kits sold person-to-person either in-person or through platforms such as eBay, Facebook Marketplace, Craigslist, etc.
    2. Select the claim form that applies to you
      1. Members residing in the United States
        1. Members residing in the United States, use the At-home Over-the-counter (OTC) COVID Test Reimbursement Form, PDF
      2. Members residing in Puerto Rico
        1. English: Members residing in Puerto Rico, please use Puerto Rico Commercial Members Reimbursement Form, Over-the-Counter COVID-19 Home Tests, PDF
        2. Spanish: Members residing in Puerto Rico, use Solicitud de Reembolso Para Suscriptores Comerciales de Puerto Rico, PDF
    3. Complete all information requested on the at-home, OTC COVID-19 test kit claim form (see step 2 for form options)
    4. Mail the completed form with the original itemized receipt and UPC code to:
      Humana Claims
      P.O. Box 14601
      Lexington, KY 40512-4601
    5. It can take up to 30 days to process your claim, and the reimbursement will be sent as a check to the address Humana has on file
    6. As of March 16, 2022, tests purchased from a trusted retailer and submitted for reimbursement will be reimbursed up to $12 per test

    IMPORTANT NOTE: If you purchase your test kit(s) using your HSA and then file for reimbursement, you are required by law to pay back your HSA account with the funds you receive from Humana. As such, for simplicity you may prefer to purchase using a different method of payment.

  3. I have a Humana Medicare Advantage or Medicaid plan. Can I get free at-home, OTC COVID-19 tests through this program?

    Beginning April 4, 2022, CMS announced Medicare beneficiaries with Part B coverage, including those enrolled in Medicare Advantage, will be eligible for up to eight (8) OTC COVID-19 tests from participating pharmacies and providers each calendar month until the end of the COVID-19 public health emergency (PHE). There may be more than 1 test per box, so 8 tests may come in fewer than 8 boxes. Those with Part A-only coverage will not be eligible.

    You can get over-the-counter COVID-19 tests at any pharmacy or health care provider that participates in this initiative even if you aren’t a current customer or patient. Check with your pharmacy or health care provider to see if they are participating. If so, be prepared to share your original red, white, and blue Medicare card and they can provide your tests and bill Medicare on your behalf. A partial list of participating pharmacies can be found at https://www.medicare.gov/medicare-coronavirus. Medicare will not cover costs for over-the-counter COVID-19 tests obtained prior to April 4, 2022.

    Additional ways to receive testing include:
    • The federal government has set up a website where each family, regardless of insurance type, can get 2 sets of 4 free at-home, OTC tests: covid.gov
    • According to the Centers for Medicare and Medicaid Services, Medicare pays for COVID-19 diagnostic tests, with no out-of-pocket costs, when the test is performed by a laboratory and ordered by a physician, or other licensed health care professional.
    • Those with Medicaid coverage should contact their state Medicaid office for information regarding the specifics of coverage for at-home, OTC COVID-19 tests, as coverage rules may vary by state.

  4. Is a referral, authorization or prescription required to obtain an at-home OTC COVID-19 test?

    Humana Commercial Group members:
    At-home, OTC COVID-19 tests do not require a referral, authorization or prescription. Humana members are eligible to receive up to 8 at-home, OTC COVID-19 tests per 30 days (or calendar month) at no out-of-pocket cost.

    Humana Medicare Advantage and Medicaid members:

    At-home, OTC COVID-19 tests do not require a referral, authorization or prescription. Humana Medicare Advantage members are eligible to receive up to 8 at-home, OTC COVID-19 tests per 30 days (or calendar month) at no out-of-pocket cost. Those with Medicaid coverage should contact their state Medicaid office for information regarding the specifics of coverage for at-home, OTC COVID-19 tests, as coverage rules may vary by state.

  5. I can’t find an at-home, OTC test in my area. What should I do?

    While Humana does not produce or distribute at-home COVID-19 tests, we do know that availability is limited due to high demand and global supply chain issues that are impacting goods of all types. We suggest checking in often with local pharmacies, stores and reputable online merchants. The federal government has also set up a website where each family can get 4 free tests: covid.gov beginning January 19, 2022.

  6. Does Humana still cover the cost of tests ordered by a physician or other licensed healthcare professional?

    Humana Commercial Group members:

    Humana Commercial Group members will continue to be eligible for COVID-19 testing with no out-of-pocket costs when a US Food & Drug Administration (FDA) or emergency use authorized COVID-19 test (including at-home tests) has been ordered by a physician or other licensed healthcare professional because the member:
    • has COVID-19 symptoms,
    • has been exposed to someone with suspected or confirmed COVID-19, or
    • requires pre-admission or pre-procedural testing in an asymptomatic individual.

    Humana Commercial Group members may NOT be eligible for coverage of COVID-19 testing for any indications other than those listed above including, but not limited to, the following:
    • Employment (e.g. pre-employment, return to work) or school purposes (e.g. return to school);
    • Entertainment purposes (e.g. prior to a concert or sporting event);
    • General population or public health screening;
    • Physicals (executive or routine);
    • Screening in a congregate setting;
    • Sports participation; or
    • Travel purposes.

    Humana Commercial Group members are encouraged to check their plan documents for more details about their 2022 coverage.

    Humana Medicare Advantage and Medicaid members:

    During the public health emergency, there will be no out-of-pocket costs for Humana Medicare Advantage and Medicaid members who receive a US Food & Drug Administration (FDA) or emergency use authorized COVID-19 test that is performed by a laboratory, when the test is ordered by a physician or other licensed health care professional. Medicare will cover one lab-performed test per member without an order. Testing locations may require an order or prescription. It is recommended that members contact the testing location for details.

  7. What if a member chooses a testing location that doesn’t accept Humana insurance?

    Humana Commercial Group members:

    Humana Commercial group members will not have out-of-pocket costs for covered COVID-19 diagnostic testing performed by an out-of-network provider. Members should refer to Question & Answer #1 in this FAQ and/or their plan documents for additional information regarding coverage for COVID-19 testing.

    Humana Medicare Advantage and Medicaid members:

    During the public health emergency, Humana will cover COVID-19 testing performed by out of network providers, without out-of-pocket cost.

  8. How can a member submit a reimbursement claim for a healthcare provider-ordered test?

    Complete all information requested on the Health Benefits Claim Form, which can be found here: Health Benefits Claim Form , PDF.
    • Enclose the original itemized bill(s)
    • Mail the completed form with the original itemized bill(s) to the address on the back of your member ID card
    • Please note it can take up to 30 days to process the claim, and the reimbursement will be sent as a check to the home address on file


  9. Do I need to schedule an appointment to get tested?

    Whether an appointment is required may vary by testing location. It is recommended that members contact the testing location for details.

  10. How long will it take to receive test results?

    Testing locations have their own protocols for processing and sharing test results with members. It is recommended that members contact the testing location for details.


COVID-19 vaccines

What you should know about COVID-19 vaccines

Vaccines are an important tool to help communities fight the spread of COVID-19 and help people stay healthy. The CDC has determined that “People who were unvaccinated had a greater risk of testing positive for COVID-19 and a greater risk of dying from COVID-19 than people who were vaccinated. Also, people who were vaccinated with a primary series and an additional or booster dose had lower case rates overall compared with those without an additional or booster dose.”1

Get the latest from the CDC about vaccines, including boosters

We strongly encourage all Humana members to consider getting the COVID-19 vaccine and booster dose(s) when they are eligible. Talk to your doctor about what is best for you.

It is important to take prevention steps to protect yourself and others, including wearing masks, practicing social distancing and washing your hands based on your COVID-19 Community Level, in order to minimize the chances of catching or spreading the disease. A level can be low, medium, or high and is determined by looking at hospital beds being used, hospital admissions, and number of new COVID-19 cases in an area.2 You can use the new COVID-19 Community Level tool to check your county’s current level and guidance for your community by visiting COVID.gov.

Source (1): CDC: Rates of COVID-19 Cases and Deaths by Vaccination Status
(2) COVID-19 by County | CDC

  1. Where can I get the vaccine?


    For more information, visit How Do I Get a COVID-19 Vaccine | CDC

  2. What should I bring to my vaccination appointment?

    Remember to bring a government-issued ID with you when you get your vaccination Because age is an important criterion for eligibility in most states, many vaccine providers are requiring a government-issued ID showing date of birth as proof of age.

    Also remember to bring your Humana Insurance member ID card (Humana Medicare Advantage members, bring your original government-issued Medicare card, too) when you get your vaccine in case the vaccine provider requests it. While the federal government is covering the cost of the vaccine for all Americans, some providers may charge a fee for administering the vaccine. There won’t be any cost to you, but having your card will ensure the provider can receive reimbursement for administering the vaccine to you. For more information on costs, see the “Will I be able to get the COVID-19 vaccine at no cost to me” FAQ below.

  3. What should I do if I’m exposed to COVID-19 or infected?

    Get the latest from the CDC on quarantine and isolation guidelines and access the CDC Quarantine and Isolation calculator to determine how long you need to isolate, quarantine or take other steps to prevent spreading Covid-19. URL: COVID-19 Quarantine and Isolation | CDC

  4. What if I am high-risk or have a specific medical condition?

    If you have concerns due to your health status or a specific medical condition, talk with your doctor about getting vaccinated.

    If you have an underlying or chronic medical condition, make sure you are in communication with your doctor during this pandemic. Getting these conditions well-managed, by staying on top of your preventive and regular medical care, will help to manage your health risk.

  5. Will I be able to get the vaccine at no charge to me?

    Yes. All Food and Drug Administration (FDA)-authorized COVID-19 vaccines will be covered at no additional cost during the public health emergency. Coverage applies no matter where you get the vaccine, including at both in-network and out-of-network providers. It also covers instances in which 2 initial vaccine doses are required, as well as booster shots that are recommended according to CDC guidelines.

    While the $0 cost share applies across Humana’s Medicare, Medicaid, and commercial plans, there are some technical differences with how claims are processed:

    • Humana Medicare Advantage members: Original Medicare was responsible for coverage of COVID-19 vaccinations during 2020 and 2021, including charges for the vaccine and its administration. Beginning January 1, 2022, the cost of the vaccine doses will be paid for by the federal government. Humana will cover any cost from vaccine providers for administering the vaccine, and there will be no cost-share for members.
    • Humana Medicaid and commercial members: The cost of the vaccine doses will be paid for by the federal government. Humana will cover any cost from vaccine providers for administering the vaccine, and there will be no cost share for members.

    Remember to bring your original government-issued Medicare card and your Humana member ID card when you get your vaccine in case the vaccine provider requests it.

    In the unlikely event you require medical treatment due to adverse effects from the COVID-19 vaccine, Humana will cover that treatment in accordance with your policy, just as with any other covered medical service or treatment.

  6. What if I was charged for my vaccine and need to be reimbursed?

    Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, some vaccination providers may charge an administration fee for giving someone the shot(s). If you’ve been vaccinated and you received a bill – either for the vaccine itself or for its administration - you can file for reimbursement directly from Humana.

    Note that there are separate claim forms for the Pfizer, Moderna and Johnson & Johnson vaccines.

    1. Complete all information requested on the appropriate health benefits claim form below:

    2. Enclose the original itemized bill(s) you paid.

    3. Mail the completed form with the original itemized bill(s) to the address on the back of your Humana member ID card.

    Please note that it can take up to 30 days to process the claim, and the reimbursement will be sent as a check to the home address we have on file for you.

  7. Should I be concerned about scams when I’m looking for the vaccine?

    Wherever you get the vaccine, it’s important to confirm the source is safe and reputable to avoid becoming a victim of fraud. A warning from the FBI in December, 2020, provides information on potential indicators of COVID-19 vaccine-related fraud and tips on how to avoid it. View the FBI’s warning here.

    If you’re a victim of a scam or attempted fraud involving COVID-19, you can:


Out-of-pocket costs related to coronavirus treatment

Is Humana covering out-of-pocket costs for treatment related to confirmed cases of COVID-19?

For the 2022 plan year, Medicare Advantage (MA) benefits include no member cost share for COVID-19 treatment. MA medical plan members will have no copays, deductibles or coinsurance for covered services for treatment of active, confirmed cases of COVID-19. This could include telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home-health and ambulance services.

Standard benefits and cost-sharing apply for COVID-19 treatment for Humana Commercial Group members (those who receive insurance through their employer). Humana Commercial Group plans will follow state requirements for COVID-19 treatment as applicable.

Medicaid plans will continue to follow state requirements for COVID-19 treatment.

Note: This does not apply to Part D-only plan members. Part D-only plan members continue to be eligible for prescription benefits.