COVID-19 testing and treatment

What to know about assessing your risk and finding a testing site

  • When should I get tested for COVID-19?

    You should get tested for COVID-19 if:


    • You are feeling sick and are experiencing symptoms of COVID-19, regardless of vaccination status or prior infection.
    • You’ve had close contact to someone with COVID-19.
    • People who are not up to date with their COVID-19 vaccine who are prioritized for expanded community screening for COVID-19.
    • Before and after travel.
    • You have been asked or referred to get tested by your healthcare provider, or state, tribal, local, or territorial health department

    You should not get tested for COVID-19 if:


    • You have tested positive for COVID-19 within the past 3 months and recovered, as long as you do not develop new symptoms
  • Find a testing site near you

    COVID-19 test availability changes daily. Call the testing site before you go to learn about testing criteria, availability, and hours.


    • Visit a Providence testing location
    • If you need only to be tested for COVID and do not need emergency care, please do not come to the Emergency Department. Instead utilize testing sites in the community (OR/WA).
    • Visit your state, tribal, or local health department’s website to find a community testing event
    • Visit your healthcare provider or public health department clinic

Over-the-Counter (OTC) at-home COVID-19 tests

  • For Providence Health Plan (PHP) Individual and Employer Group health plan members

    Beginning January 15, 2022, Providence will cover most individual and employer group health plan members’ FDA-authorized Over-the-counter (OTC) at-home COVID-19 diagnostic tests purchased on or after January 15, 2022, without a doctor’s prescription. This benefit for OTC at-home COVID-19 test includes up to 8 tests per member age 2 and older every 30 days.

  • For Providence Health Assurance (PHA) Medicare Advantage plan members

    PHA will cover FDA-authorized OTC at-home COVID-19 diagnostic test purchased on January 15, 2022 through April 14, 2022, without a doctor’s prescription. This benefit for OTC at-home COVID-19 test includes up to 8 tests per member every 30 days.


    Effective April 15, 2022, members with Original Medicare Part B coverage including those enrolled in a Medicare Advantage plan can get up to 8 free OTC at-home COVID-19 tests for each calendar month at authorized pharmacies or other participating entities through the end of the federal public health emergency. Members will be able to receive the OTC COVID-19 tests at no cost and will not need to be reimbursed, as Original Medicare will pay the pharmacy or other entity directly. Bring your red, white and blue Medicare card to get your free tests, even if you have a Medicare Advantage or Medicare Part D plan, in the event the pharmacy needs your Medicare information. You can learn more about this program here.

  • For Providence Health Assurance (PHA) Medicaid Plan Members

    PHA will cover FDA-authorized OTC at-home COVID-19 diagnostic test purchased on March 11, 2021 through February 17, 2022, without a doctor’s prescription. This benefit for OTC at-home COVID-19 test includes up to 4 tests per member every 30 days.


    PHA will cover FDA-authorized OTC at-home COVID-19 diagnostic test purchased on or after February 18, 2022, without a doctor’s prescription. This benefit for OTC at-home COVID-19 test includes up to 8 tests per member every 30 days.

  • For anyone to get OTC at-home COVID-19 test from the Federal government

    Every home in the U.S. is eligible to order 8 free OTC at-⁠home COVID-⁠19 tests. The tests are completely free. Orders will usually ship in 7-12 days. Visit https://www.covidtests.gov/ to order your free at-home tests

OTC at-home COVID-19 testing frequently asked questions

  • Do I need a prescription to obtain a free OTC at-home COVID-19 test?

    No, you do not need a prescription for the first eight OTC at-home COVID-19 tests to diagnose the presence of illness for coverage. Visit any Providence pharmacy counter to request one and the pharmacy can bill your insurance directly.

  • What tests are covered?

    All FDA-approved or FDA-authorized diagnostic OTC tests used to diagnose COVID-19. These antigen tests are typically self-administered and self-read, known as “at-home” tests that you can buy without a prescription. View complete FDA-approved OTC tests here, search OTC for easier viewing.

  • Why are OTC COVID-19 tests an important part of you, your family, and your friends COVID-19 prevention plan?

    Over the counter (OTC) COVID-19 tests can detect current COVID-19 infections. OTC COVID-19 tests are convenient as they can give you results in a few minutes and can be taken anywhere, not just in a doctor’s office.


    By using OTC COVID-19 tests you can see if you have a COVID-19 infection and can help prevent the spread of COVID-19 by taking the appropriate measures of staying at home for at least 5 days and isolating from other in your home. In this way, having OTC COVID-19 tests easily accessible to use can help to protect yourself, your family, and your friends from spreading COVID-19.

  • Where can I buy an OTC COVID-19 test?

    OTC COVID-19 tests can be found at retail pharmacy locations or you may order online directly. If you visit an in-network pharmacy, the pharmacist can order and can bill your insurance directly at no cost to you. A list of current in-network pharmacies can be found here.


    Direct-to-Home Order through the Costco Pharmacy website. Please note that all Providence members may order and utilize the Costco Pharmacy website. OTC tests contain 5 tests per package; each member is allowed up to 10 tests (2 x 5 test packages) per 30-day period because of this special arrangement with Costco for direct-to-home delivery via the Costco Mail Order Pharmacy



    If you purchase an OTC COVID-19 test directly without insurance, save your receipt and submit your reimbursement by filling out the COVID-19 at-Home test reimbursement form and sending it to Providence at the address on the back of your ID card. Effective March 15, 2022, we will reimburse via direct member reimbursement up to 8 tests per member (up to $12 per test) over a 30-day period.


    Retailers may have per-person limits due to high demand for tests and limited availability. Coverage for OTC Covid-19 tests is currently only planned through the end of the pandemic due to regulations from Health & Human Services. We will update this information as new information becomes available.

  • How can I get reimbursed?

    If you buy an OTC test through your local in-network pharmacy, you will have no cost share and the pharmacy will bill your health plan directly.


    If you do not buy your test through a local in-network pharmacy that bills your health plan directly you may submit a COVID-19 at-home test reimbursement form. Follow instructions on the form and include your receipt. Effective March 15, 2022, we will reimburse via direct member reimbursement up to 8 tests per member (up to $12 per test) over a 30-day period.

  • Can I use my Health Savings Account (HSA)/ Flexible Spending Arrangement (FSA)? Does it affect my reimbursement?

    Yes, you can use your HSA/FSA account. Under previous guidance, the cost of OTC tests for COVID-19 is eligible to be paid or reimbursed under HSA or FSA account for diagnostic purposes only. You are not eligible for reimbursement from your HSA/FSA if you are reimbursed by insurance.

  • Are there other ways to get a free OTC COVID-19 test?

    Yes. Every home in the U.S. is eligible to order 8 free OTC at-⁠home COVID-⁠19 tests. The tests are completely free. Orders will usually ship in 7-12 days. Visit https://www.covidtests.gov/ to order your free at-home tests.


    In addition, Washington residents of eligible communities can order free OTC at-home COVID-19 tests for their household here.

  • Learn more about how to avoid buying fake COVID-19 test kits

    The Federal Trade Commission published information on how to avoid buying fake COVID-19 test kits. Learn more here.

Testing coverage

  • What is my COVID-19 testing coverage?

    Currently, medically appropriate COVID-19 tests have a $0 cost-share. Medically appropriate COVID-19 tests are those that are either FDA authorized or approved and ordered or reviewed by a health care professional to either 1) diagnose due to symptoms or potential exposure, or 2) help in the treatment of the virus for a person. This benefit coverage applies to both in-network and out-of-network tests for Medicare Advantage, Individual (marketplace and direct) and employer-sponsored health plans.


    • Providence generally does not cover COVID-19 testing for public health surveillance or employment purposes. State variations and regulations may apply.
    • Remember to visit network health care providers and always show your Providence member ID card for COVID-19 testing or related services.

Treatment

  • Treatment for COVID-19 that can be taken by mouth and you can pick up at the pharmacy

    Paxlovid and Molnupiravir are the first two medications for treatment of COVID-19 authorized by the FDA via emergency use authorization (EUA) to be taken by mouth for individuals who are not hospitalized.


    These two antiviral medications are only available with a prescription from a health care provider and should be started as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.


    Paxlovid and Molnupiravir are not authorized for use as pre-exposure prophylaxis or post-exposure prophylaxis for prevention of COVID-19.


    • Paxlovid is authorized by the FDA for treatment of mild-to-moderate COVID-19 for adults as well as children age 12 and older weighing at least 40 kg (88 pounds) who are at high risk of severe COVID-19 because of age or underlying medical conditions.
    • Molnupiravir is authorized by the FDA for treatment of mild-to-moderate COVID-19 in adults age 18 and older who are at high risk of severe COVID-19 and for whom alternative COVID-19 treatment options authorized by the FDA are not accessible or clinically appropriate.

    As of January 2022, Paxlovid and Molnupiravir medications are distributed by the federal government and state health departments to select locations where states determined the treatment was needed most. Check your local health department for more information on what locations have access to these medications.


    If you recently tested positive for COVID-19, talk to your healthcare provider to see if COVID-19 antiviral medications, Paxlovid or Molnupiravir, taken by mouth are right for you.


    Treatment is not a substitute for vaccination against COVID-19. Vaccines are the best protection from COVID-19, help to slow transmission of COVID-19, and reduce the likelihood of new variants emerging.

    For more information on possible treatment options for COVID-19, please visit the U.S. Department of Health Services’ CombatCOVID website. 

  • Out-of-hospital treatment options for COVID-19 given by a healthcare professional

    Members should first talk to their healthcare provider about treatment options before seeking to take the following medications.


    Remdesivir, an antiviral medication, is FDA approved for individuals who are not hospitalized. Remdesivir works by stopping COVID-19 from spreading in the body.


    • Remdesivir is approved by the FDA for treatment of COVID-19 for adults as well as children age 12 and older weighing at least 40 kg (88 pounds) who have a positive result of COVID-19 viral testing are at high risk
    • Remdesivir is authorized by the FDA via EUA for children under age 12 and under 40 kg (88 pounds) who have a positive result of COVID-19 viral testing and are at high risk

    Monoclonal antibodies (mABs) have been issued emergency use authorization (EUA) by the FDA for patients who are not hospitalized. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses.


    • Monoclonal antibodies are available for individuals ages 12 years or older who:
      • Are at high risk of getting more serious symptoms and
      • Have tested positive for COVID-19 and have had symptoms for 7 days or less (bebtelovimab) or
      • Have been in close contact with someone who has recently tested positive

    • The following monoclonal antibodies have emergency use authorization (EUA) for COVID-19 are still effective against the current variant of COVID-19:
      • Tixagevimab & Cilgavimab (EVUSHELD) for pre-exposure prophylaxis of COVID-19 for adults as well as children age 12 and older weighing at least 40 kg (88 pounds) who are not currently infected with COVID-19 and who have not had a known recent exposure to an individual infected with COVID-19 and
        • Who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and may not amount an adequate immune response to COVID-19 vaccination or
        • For whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe adverse reactions (e.g., severe allergic reaction) to a COVID-19 vaccine and/or COVID-19 vaccine component.

      • Bebtelovimab for COVID-19 treatment for adults as well as children age 12 years and older weighing at least 40 kg (88 pounds) who have tested positive for COVID-19 and who are at high risk for progressing to severe COVID-19 and for whom alternative treatment options approved or authorized are not accessible or clinically appropriate

    HHS also has a national map that displays locations that have received shipments of monoclonal antibodies within the past several weeks. Members should talk to their healthcare provider before contacting a location to receive treatment.


    Additionally, the U.S. Department of Health and Human Services (HHS) has a call center available to answer questions and provide information related to monoclonal antibody therapeutic treatments at the following phone numbers: 1-877-332-6585 (English language); 1-877-366-0310 (Spanish language).


    Treatment is not a substitute for vaccination against COVID-19. Vaccines are the best protection from COVID-19, help to slow transmission of COVID-19, and reduce the likelihood of new variants emerging.

    For more information on possible treatment options for COVID-19, please visit the U.S. Department of Health Services’ CombatCOVID website. 

  • Where can I find some of these therapy options for COVID-19?

    COVID-19 therapies that are provided by shipments of U.S. Government can be found on the Office of the Assistant Secretary for Preparedness & Response national map: COVID-19 Therapeutics Locator.


    Currently, therapy found on the COVID-19 Therapeutics Locator includes:

    • Evusheld
    • Molnupiravir
    • Paxlovid
    • Bebtelovimab

    For more information on possible treatment options for COVID-19, please visit the U.S. Department of Health Services’ CombatCOVID website.

  • Treatments no longer effective against COVID-19 variants

    Based on the changed genetic make-up of COVID-19 variants, like Omicron, some treatments are likely to remain effective while others may be less effective.


    COVID-19 treatments that are currently not authorized for use by the FDA due to not being effective against the current COVID-19 variant include the following monoclonal antibody therapies:


    • Bamlanivimab
    • Bamlanivimab & Etesevimab
    • Casirivimab & Imdevimab (REGN-COV)
    • Sotrovimab

Treatment coverage

  • What is my COVID-19 treatment coverage?

    Effective 1/1/2022, standard member cost share will apply to medical treatment services for COVID-19. The standard member cost share will be waived for Paxlovid and Molnupiravir medications.


    To view your benefits and plan details, log in to your myProvidence account.

Have questions?

We're here to help you understand your comprehensive coverage and access genuine care. Call our customer service team at 800-878-4445 (TTY:711) Monday through Friday, 8 a.m. to 5 p.m. (Pacific Time).

Need help?

Hey!

You are now leaving the Providence Medicare Advantage Plans website. Are you sure thats what youd like to do?

No, I'll stay Yes, I'm leaving