COVID-19 benefits

Humana Commercial Group (those who receive insurance through their employer), Medicare Advantage and Medicaid members:

Yes. However, starting May 12, 2023, the amount you will be required to pay for covered COVID-19 benefits – including testing, testing-related services and treatment – may change. Visit MyHumana.com or call the number on the back of your Humana member ID card for more details on changes to COVID coverage requirements beginning May 12, 2023.

Humana Commercial Group members:

Out-of-pocket costs for covered COVID-19 testing may vary by plan, but in general will be similar to other common diagnostic tests, such as influenza. Please refer to MyHumana.com or call the number on the back of your card to learn more.

Please note: Puerto Rico members will continue to have $0 cost share.

Humana Commercial Group members will continue to be eligible for COVID-19 testing 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 Medicare Advantage members:

After the COVID-19 PHE ends, applicable member cost share would apply for covered COVID-19 testing.

You can verify your member plan benefits by logging in to MyHumana.com or calling the number on the back of your card to learn more.

Humana Medicaid members:

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

Humana Commercial Group members:

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.

Humana Commercial Group and Humana Medicare Advantage members:

No. Access to free at-home, OTC COVID-19 tests will end when the COVID-19 PHE ends on May 11.

Humana Medicaid members

State Medicaid programs must provide coverage without cost sharing for COVID-19 testing until the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE. That means with the COVID-19 PHE ending on May 11, 2023, this mandatory coverage will end on September 30, 2024, after which coverage may vary by state.

Humana Commercial Group members:

On January 15, 2022, the U.S. Department of Health and Human Services announced that 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. This program will end on May 11. However eligible test kits purchases may be reimbursed if bought prior to May 12. Submitted 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. You may find them at local pharmacies, local stores or trusted online retailers.

To submit an OTC COVID-19 test kit purchase made prior to May 12, 2023, for reimbursement:

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
   
   Please note: For tests purchased before 6/10/2022, the form must be mailed by 455 days from the date of purchase. For tests purchased between 6/10/2022 and 5/11/2023, the form must be mailed by 9/8/2023.
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.

Humana Commercial Group members:

Yes. COVID-19 vaccines will continue to be covered at $0 cost share when you visit an in-network provider. Vaccines administered by an out-of-network provider will be subject to plan cost-sharing.

Humana Medicare Advantage members

There will continue to be a $0 cost share for COVID-19 vaccines across Humana’s Medicare Advantage plans.

Humana Medicaid members:

Medicaid plans will follow state requirements for coverage of COVID-19 vaccines.