Coronavirus

Molina understands how challenging the Covid-19 virus has been on the families and communities that we serve. With testing and vaccination plans continuing to evolve, we are committed to keeping you informed of the latest developments. Please visit this page regularly for updated information regarding Molina's response to the virus and the resources available to you.

Latest Developments:

Molina covers COVID therapeutics.

• COVID therapeutics (medications and antibodies) for people who test positive for COVID are proving effective in preventing serious illness, hospitalizations, and deaths.
• COVID therapeutics are most effective within seven days of when symptoms start.
• Members who have a positive home COVID test should contact their provider or Molina Member Services to see if a therapeutic is appropriate.
• Prior Authorization is not required.

Order free at home test kits directly from the government beginning on January 19th:

• Every home is eligible for up to 4 free test kits
• Test kits will be shipped directly to you at no cost
• Visit https://www.covidtests.gov/ for more information on the program.

Over-the-counter COVID-19 home tests

Molina Marketplace will reimburse for over-the-counter COVID-19 home tests that meet the below requirements during the Public Health Emergency.

Steps for purchasing a covered test:

1. Purchase an FDA approved or Emergency Use Authorized rapid antigen test from a pharmacy, store or online. This will be indicated on the packaging.
2. Keep your test kit box and receipt as they both have important information you will have to reference when filing your claim.

*Please note:

• No prior authorization, prescription or provider direction is needed for these covered home COVID tests.
• Reimbursement is limited to 8 total tests per member for personal use in a 30-day (or one month) period. Note, sometimes tests come in packs of two. Each test counts towards your total limit of 8.
• COVID tests for employment or school testing purposes are not covered.

Steps for Reimbursement:

Qualifying COVID-19 home test costs can be reimbursed to Molina Marketplace members in three ways:

1. Make a digital claim through the Caremark mobile app
2. Make a digital claim through a registered profile on Caremark.com
3. Mail in your claim by using our At Home COVID Kit Reimbursement Claim Form.
   1. Some of the questions marked “required” on our standard form do not apply to over the counter home test kits for COVID-19. You do not need a prescriber or a prescription number for your over the counter (OTC) test.

*Please note:

• With your claim you will need to include a clear image of your receipt that shows: the date your test was purchased, the brand of your test kit, the full number under your test barcode.
• You must be enrolled in the plan to participate
• Reimbursement is not guaranteed if all steps and conditions are not satisfied.
• Keep a copy of all documents submitted for your records

Frequently Asked Questions:

Molina's Current Testing Coverage for Marketplace Members:

Molina Marketplace will reimburse for over-the-counter COVID-19 home tests that meet the below requirements during the Public Health Emergency

1. Purchase an FDA approved or Emergency Use Authorized rapid antigen test from a pharmacy, store or online. This will be indicated on the packaging.
2. Keep your test kit box and receipt as they both have important information you will have to reference when filing your claim.

*Please note:

• No prior authorization, prescription or provider direction is needed for these covered home COVID tests.
• Reimbursement is limited to 8 total tests per member for personal use in a 30-day (or one month) period. Note, sometimes tests come in packs of two. Each test counts towards your total limit of 8.
• COVID tests for employment or school testing purposes are not covered.

Molina also covers Covid-19 testing without being charged a co-pay or cost share when ordered or given by a provider. For further details please consult your Explanation of Benefits (EOB)

Molina Covers the COVID-19 Vaccine for Marketplace Members:

Molina covers the cost of the COVID-19 vaccination without members being charged a co-pay or cost share.

Where Can Members Get A Vaccine?:

Use the below tools to help you locate a COVID-19 vaccine in your area.

• https://vaccinefinder.org/
• COVID-19: Vaccine information | CVS Health

For additional details regarding vaccine availability and distribution in your area, please go to your states official Covid-19 resource page below: