Tompkins County Health Consortium

The Department of Labor issued guidance on January 10th regarding free At-Home COVID Test Kits for an effective implementation date of January 15, 2022.  Our providers are working hard to get their systems in place to best serve our members and get all your questions answered.  With such a short implementation window this is still a work in progress, and we will update you as their systems are reorganized to meet this new mandate.

Starting January 15th, all covered employees under the Health Consortium (GTCMHIC) can go to a participating pharmacy to purchase an at-home over the counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their ProAct insurance. As of today, below is what ProAct will have in place.

  • ProAct will be following the recommended limit of 8 tests per member per 30 days. Many in home test kits come with 2 tests in 1 box and each test will count towards this limit.

  • No prescription is needed.

  • The test must be U.S. Food and Drug Administration (FDA) authorized, but no other limits will be placed on the type of test a member is able to purchase under the plan.

  • To help ensure coverage, members will need to use a participating ProAct pharmacy.  To find participating pharmacies  visit ProAct Pharmacy Network Finder Tool.

 

ProAct will be working hard throughout the next few days to have all related coding in place for January 15, 2022, but they cannot guarantee everything will be complete.  Therefore, if a member goes to the pharmacy to get an in-home test kit on January 15th and the coding is not complete, they will be able to file a Direct Member Reimbursement (DMR) claim form (see attachment) and be reimbursed for the cost of the test kit based on CMS reimbursement guidelines. Copies of the receipt of purchase will be needed.

Link to Reimbursement Form
pic%20covid%20test.png

 

Thank you for your patience as we work quickly to follow these new mandates. If your member has any issues, we recommend directing them to ProAct Customer Service 1-877-635-9545 or to reach out to the Consortium Benefit Specialist, Kylie Rodrigues, krodrigues@tompkins-co.org or direct line (607) 274-5933.

Total Amount SpentCOVID Test KitsDate of Purchase