Yes. These tests, defined as those that are approved by the FDA under the Emergency Use Authorization and are self-administered and self-read at home without involvement from a medical provider, are covered for all Employer Group, Individual and Self-Funded members. At-home antigen tests purchased on or after January 15, 2022 are covered with no cost-sharing if they are obtained at a pharmacy on the At-home OTC COVID-19 Test Preferred Pharmacy List. This coverage applies for the duration of the public health emergency.
Employer Group, Individual or Self-Funded SummaCare members can obtain up to eight tests per member per 30 days for $0 if processed at a preferred pharmacy—even without a prescription. Please note that if a kit includes two tests, both count toward the eight-test limit. A list of preferred pharmacies is available here.
However, if members obtain an at-home test at a non-preferred pharmacy, a reimbursement request can be submitted to MedImpact and will be processed at the non-preferred rate of up to $12 per test.
|Self-Funded Client||At-Home COVID-19 Testing Resource|
|Summa Health Employee Plan||MedImpact|
|Summa Home and Hospice||MedImpact|
|Community Health Care||MedImpact|
|City Of Kent||Federal Government|
Medicare Advantage members may use their OTC allowance to purchase at-home tests through SummaCare’s OTC vendor, Convey. Once your OTC quarterly allowance limit is reached, we invite you to visit Find a Health Center to search for locations near you offering free testing.
To obtain reimbursement, you attest that the at-home OTC COVID-19 antigen test meets the following requirements:
If you are an Employer Group, Individual or participating* Self-Funded SummaCare member, you can submit a reimbursement request to MedImpact by visiting the MedImpact website or by calling the number on the back of your ID card.
*The only participating self-funded SummaCare groups at this time are Summa Health, Summa Home Health and Hospice, Pioneer Physicians Network and Community Health Care (CHC). (Please note that coverage for self-funded plans may vary.)
Yes. SummaCare covers COVID-19 testing for all members, with no co-pays or deductibles, for items and services related to provider-ordered testing for COVID-19 (i.e. office visits, emergency and urgent care visits, telehealth visits) whether in network or out-of-network. If Employer Group, Individual or Self-Funded members receive the test by an out-of-network provider they may be balance billed. This coverage applies for the duration of the public health emergency.
SummaCare will continue to follow the guidance and protocols issued by the U.S. Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), and state and local public health departments. Based on current CDC recommendations, call your physician if you believe you have been exposed to COVID-19 or have symptoms that may indicate the need for testing. The majority of patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness such as cough or difficulty breathing. Your physician may need to test for other causes of respiratory illness, such as influenza, before ordering a COVID-19 test.
If you are 65 or younger and have possible symptoms of COVID-19, please visit summahealth.zipnosis.com to start the FREE online screening process.
If you are over the age of 65 and have possible symptoms of COVID-19, contact your doctor’s office. Do not travel to a medical facility unless you are instructed to do so. You can also call the Summa Health 24/7 COVID-19 hotline to speak with a trained nurse at 234.867.6314.
Please be aware of COVID-19 testing scammers who may be attempting to contact you via telemarketing phone calls, social media and home visits. Always protect your personal information. A COVID-19 test should only be ordered by a trusted medical provider. For more information, please read this important fraud alert from the U.S. Department of Health and Human Services Office of Inspector General.
Symptom management for COVID-19 is subject to the same copays, coinsurance and/or deductibles that would apply to other tests and treatment (such as flu or other viral infection). For additional questions about your coverage, please call the number on the back of your ID card.
Yes. SummaCare covers provider-ordered antibody blood testing that determine whether you have been infected with COVID-19 with no copays or deductibles for all members (i.e. Medicare Advantage, Individual, Employer Group and Self-Funded) whether in or out-of-network. This coverage applies for the duration of the public health emergency.
A COVID-19 antibody blood test should only be ordered by a trusted medical provider. Check with your doctor to determine if they offer antibody tests.