Vermont Business Magazine Kinney Drugs, a 100% employee-owned leading pharmacy chain in New York and Vermont, has issued an operational update in light of President Biden’s recent announcement of “free” at-home COVID antigen tests for Americans. Federal mandates are slated to go into effect January 15, 2022. In Vermont, this mandate is already in effect.
It is VERY IMPORTANT that the public understand that:
- These tests are not actually FREE, but are reimbursed by insurance.
- At this time, only two insurers – Medicaid and Blue Cross/Blue Shield of VT – are set up to adjudicate these OTC tests as prescriptions with no out-of-pocket costs.
- For all other plans at this time, the patient must purchase the test over-the-counter and submit it for reimbursement.
- Different insurers are reimbursing different tests. Patients should therefore check with their insurers before purchasing a test to ensure that will be covered.
Tests will be covered by insurance in one of two ways:
- The patient will present insurance documentation to the pharmacy, and the test will be processed electronically as a prescription with no out-of-pocket cost to the patient. At this time, the availability of Option #1 is limited to Medicaid and BC/BS (Blue Cross & Blue Shield of Vermont) insurances.
OR, more frequently:
- The patient will purchase the test over the counter and then submit the receipt with their insurance company's required form(s) directly to their insurer for reimbursement. Each insurer has different requirements. Kinney Drugs recommends that before completing a purchase, patients should check with their insurer to confirm that the test they are purchasing will be covered for reimbursement. Different insurers are covering different tests.
In addition, some national insurers may be unaware that the Vermont-specific mandate requiring them to cover at-home COVID tests took effect earlier than the national mandate, which takes effect January 15, 2022.
Further guidance from health officials and insurers (about the process and what specific tests are covered) is forthcoming.
To date, no official guidance has been issued for those individuals without health insurance.
As more information is made available, necessary processes and systems are put in place, and supply of covered test kits is secured, Kinney Drugs will expand at-home testing options to the fullest extent possible. Kinney Drugs cannot rebill &/or refund past claims for at-home COVID tests.
“As a pharmacist and President of Kinney Drugs, I am glad that we are able to expand access to affordable at-home COVID antigen testing,” said John Marraffa, R.Ph., President of Kinney Drugs. “Our Kinney pharmacy teams are committed and determined to help our communities end this pandemic.”
About Kinney Drugs: Founded in Gouverneur, NY in 1903, today the independent, employee-owned company operates 96 stores in New York and Vermont. Kinney Drugs is part of the KPH Healthcare Services family of companies, a national provider of pharmaceutical and healthcare services with complementary businesses in both the retail and commercial segments of the industry. KPH is comprised of eight divisions: (1) Kinney Drugs, a chain of full-service drug stores located throughout New York and Vermont; (2) Health Direct Institutional Pharmacy Services, which serves long-term care and alternative care needs; (3) ProAct, Inc., a pharmacy benefit management company with sales offices throughout the country and a mail-order pharmacy; (4) Noble Health Services, a specialty pharmacy that dispenses medications used to treat complex and chronic diseases; (5) Kinnect™, an on-site clinical care pharmacy; (6) Aristacare, an infusion therapy pharmacy; (7) HomeLife specialized nursing support for in-home infusion services; and (8) Marra’s Homecare, a durable medical equipment company. KPH Healthcare Services is an employee-owned company with approximately 4,450 employees that provides the highest quality pharmacy and healthcare services. Every aspect of KPH’s business is guided by the values of excellence, moral responsibility, and community spirit. Learn more at www.kinneydrugs.com.