FEHB Coverage of COVID-19 Over-The-Counter Tests, Vaccines, and Therapeutics

Based on FEHB Carrier Letter 2022-01 issued by the Office of Personnel Management (OPM) on coverage for countermeasures against COVID-19, Federal Employees Health Benefits (FEHB) Carriers must follow Frequently Asked Questions (FAQs) Part 51 issued by the Departments of Labor, Health and Human Services, and Treasury in providing coverage of over-the-counter (OTC) COVID-19 tests through FEHB plans. This coverage must be provided without imposing any cost-sharing requirements, prior authorization, or other medical management requirements.

FEHB plans may place a limit of eight OTC COVID-19 tests per covered individual per month at no charge. That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their FEHB plan per month at no charge. Generally, there is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.

Questions about coverage may be directed to your health plan at the number on the back of your health ID card.