COVID-19 Resources, Vaccines, and At-Home Tests

Effective January 15, 2022 and through the end of the Public Health Emergency (PHE) period, OTC tests that are approved under the FDA emergency use authorization (EUA) in vitro diagnostics will be covered at $0 cost to the customer, without a health care provider order or individualized clinical assessment. If you purchase an over-the-counter COVID-19 test from a pharmacy, store, or online retailer and are charged for your test, keep your receipt and submit a claim to Cigna for reimbursement. You will be reimbursed the costs of diagnostic OTC testing, regardless of where the tests are obtained (in- or out-of-network). Your plan can provide this coverage through reimbursement to you. Your plan can require you to sign an attestation that the test:

• Was purchased for the covered individual;
• Is not for employment purposes;
• Has not and will not be reimbursed by another source, and
• Is not for resale.

Your plan may require reasonable documentation of proof of purchase with a claim for reimbursement for the cost of an OTC COVID-19 test. Examples of such documentation could include the UPC code for the OTC COVID-19 test and/or a receipt from the seller of the test, documenting the date of purchase and the price of the OTC COVID-19 test.

You can now submit a COVID-19 test kit claim form online for tests purchased on or after January 15, 2022. Submit a claim online

Or, download the COVID-19 Over-the-Counter (OTC) Test Kit Claim Form [PDF] and submit via mail or fax using the instructions on the form.*

Your plan covers tests that the U.S. Food and Drug Administration (FDA) authorizes. Visit the FDA website for a list of authorized tests.

Tests you purchase on or after January 15, 2022 are eligible for reimbursement. Tests you purchase on or after January 15, 2022 are eligible for reimbursement. However, the following are not reimbursable under this program:

• The BinaxNOW^TM test with “Telehealth Proctor Supervised” in the attributes column
• The Cue+ Essential^TM membership
• The Cue Reader

Your plan may limit the number of tests reimbursed to no less than eight OTC COVID-19 tests per covered individual per 30-day period (or per calendar month). In applying the quantity limit of eight, plans and issuers may count each test separately, even if multiple tests are sold in one package.

This limit only applies to OTC COVID-19 tests purchased and administered at home without the involvement of a health care provider. This means your health plan must still cover other kinds of COVID-19 tests ordered or administered by a health care provider. Those tests don’t count toward the eight quantity limit.

Oscar + Cigna customers can visit the Oscar website for more information about obtaining OTC test kits.

Tests for SARS-CoV-2 (the virus that causes Covid-19) are approved for home use under FDA in vitro diagnostics emergency use authorization, or antigen tests. Antigen tests detect the presence of specific virus proteins present on the sample swabbed from your body. Though rapid (results in 10-15 minutes) and convenient, they are not as good at detecting the virus as the type of test performed in a laboratory (known as nucleic acid amplification testing or NAAT), which is extremely sensitive.

An antigen test is most likely to detect the SARS-CoV-2 virus when taken soon after symptoms develop (or 5 days after a known exposure without symptoms). A negative self-test result means that the test did not detect the virus and you may not have an infection, but it does not rule out infection, especially if you have symptoms. Repeating the test within a few days, with at least 24 hours between tests, will increase the confidence that you are not infected.

Regardless of which test is performed, if your result is positive you should follow CDC guidance on COVID-19 quarantine and isolation.

The Test-to-Treat initiative is part of President Biden’s National COVID-19 Preparedness Plan. Through this program, there are hundreds of “one stop test-and-treat” locations nationwide. Those who test positive for COVID-19 at one of those locations may also get a prescription filled for oral antivirals, if appropriate. You can search for test-to-treat locations near you using the U.S. Department of Health & Human services’ website locator.

Please see the Care and Coverage section below for coverage information about testing, diagnosis and treatment options.

Cigna Medicare Advantage plans currently do not pay for or reimburse your costs for the purchase of at-home COVID-19 tests. If you purchase at-home test kits on your own, your plan will not reimburse you for the cost.

However, you do have two options for getting free COVID-19 (OTC) test kits:

1. Medicare beneficiaries can get up to 8 tests per month from participating national pharmacies and health care providers: For more information and to get a list of participating pharmacies and health care providers, visit Medicare.gov.
2. All Americans can order up to 8 free tests from COVIDtests.gov: Tests are expected to ship 7–12 days from the order date. If you need help placing an order, call 1 (800) 232-0233, 8 am-midnight, ET, 7 days a week (TTY: 1 (888) 720-7489). Help is available in English, Spanish, and more than 150 other languages.

Cigna Medicare Advantage plans fully cover the costs of COVID-19 tests done in a clinical setting, through the end of the declared Public Health Emergency (PHE) period. That means your Cigna Medicare plan covers COVID-19 testing without any out-of-pocket costs when it’s ordered by your doctor or done in an approved facility. To find a community-based testing site near you, visit HHS.gov.

Cigna Medicare Advantage plans currently do not pay for or reimburse your costs for the purchase of at-home COVID-19 tests. However, you do currently have these other options for COVID-19 testing:

• Visit HHS.gov to find a community-based testing site near you
• Purchase at-home test kits on your own

Through the end of the declared Public Health Emergency (PHE) period, Cigna Medicare Advantage plans fully cover the costs of COVID-19 tests done in a clinical setting. That means your Cigna Medicare plan covers COVID-19 testing without any out-of-pocket costs when it’s ordered by your doctor or done in an approved facility.

In addition, on January 14, 2022, the White House announced a plan to ship up to four rapid COVID-19 tests to residential households for free. Since January 19, you can order the tests online at COVIDtests.gov. The tests are expected to ship 7 – 12 days from the order date. If you have trouble going online or need help placing an order, call 1 (800) 232-0233. Help is available in English, Spanish, and more than 150 other languages. And this call line is open 8 am until midnight Eastern Time, 7 days a week. If you’re hearing impaired, you can use their TTY line, 1 (888) 720-7489.

Also, on February 3, 2022, CMS announced a new initiative for free over-the-counter COVID-19 tests. Starting in early spring, anyone with Medicare Part B will be able to get up to eight free over-the-counter COVID-19 tests per month, whether enrolled in a Medicare Advantage plan or not. The tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests that are approved or authorized by the U.S. Food and Drug Administration (FDA). And Medicare will pay the eligible pharmacies and entities directly.

Everyone five years of age and older is eligible to get a COVID-19 vaccination.

There are several ways to find a vaccination location near you:

• Visit Vaccines.gov
• Text your zip code to 438829 or call 1 (800) 232-0233
• Check your local pharmacy’s website for available appointments
• Find pharmacies participating in the Federal Retail Pharmacy Program
• Contact your state health department

Note in some states, information may be limited while more vaccination providers and pharmacies are being added.

Learn more at Vaccines.gov

There are three vaccines available in the U.S. The Pfizer-BioNTech vaccine is FDA-authorized for ages 5-15 and FDA approved for ages 16 and older. The Moderna^® and Johnson & Johnson^® vaccines are FDA-authorized for ages 18 and older.

Yes.  Studies show after getting vaccinated against COVID-19, protection decreases over time. The recent emergence of the Omicron variant further increases the importance of vaccination and boosters to protect against COVID-19.

Everyone ages 12 and older can now get the Pfizer-BioNTech COVID-19 Vaccine booster shot.  Individuals can receive the Pfizer-BioNTech booster at least 5 months after completing the primary COVID-19 vaccination series.

A third primary series dose for certain immunocompromised children ages 5 through 11. Children 5 through 11 years of age who have undergone solid organ transplantation, or who have been diagnosed with conditions that are considered to have an equivalent level of immunocompromise, may not respond adequately to the two-dose primary vaccination series. Thus, a third primary series dose has now been authorized for this group. This will now allow these children to receive the maximum potential benefit from vaccination.

Children 5 through 11 years of age who are fully vaccinated and are not immunocompromised do not need a third dose at this time.

It’s now recommended that you get your booster shot five months after your last shot if you got the Pfizer-BioNTech vaccine, six months later if you got the Moderna vaccine, and two months later if you got the Johnson and Johnson/Janssen vaccine.

For detailed information about COVID-19 booster shots, visit the FDA website.

It is your preference. The CDC recommendations now allow for mix and match dosing for booster shots. You can get a booster of the vaccine that you originally received, or you can get a different vaccine type for your booster.

For the latest recommendations on eligibility of booster shots, including recommendations for the general population, refer to COVID-19 Vaccine Booster Shots | CDC or talk to your health care provider.

Yes, as of October 29, 2021, the U.S. Food and Drug Administration authorized the emergency use of the Pfizer-BioNTech COVID-19 Vaccine for children five through 11 years of age.

• The vaccine was found to be 90.7% effective in preventing COVID-19 in children five through 11 years of age.
• Safety: The vaccine’s safety was studied in approximately 3,100 children age five through 11 years who received the vaccine. No serious side effects have been detected in the ongoing study.

The Pfizer-BioNTech COVID-19 Vaccine for children five through 11 years of age is administered as a two-dose primary series, three weeks apart, but is a lower dose (10 micrograms) than that used for individuals 12 years of age and older (30 micrograms).

If you are a parent or guardian with questions about the vaccine, we encourage you to talk with your child’s health care provider.

For more information you can read:

• The FDA decision to authorize the use of the Pfizer-BioNTech COVID-19 vaccine for 5-11 year olds
• CDC Recommends Vaccine for Kids ages 5-11

Cigna looks to the U.S. Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and input from the Advisory Committee on Immunization Practices (ACIP) to determine these factors.

It has been shown that all three COVID-19 vaccines currently available in the United States are highly effective at preventing COVID-19.

To learn more about the vaccines, visit:

Different COVID-19 Vaccines | CDC

Vaccines | FDA

The best way to protect against influenza (flu) and COVID-19 is to get vaccinated. The flu and COVID-19 are contagious respiratory diseases that can lead to serious illness, hospitalization, or even death. We encourage everyone to talk with their health care provider about getting the COVID-19 and the flu shot. You can get both shots at the same time.

COVID-19 and flu vaccinations are safe and effective and may help avoid serious complications and hospitalization.

Yes, you should be vaccinated regardless of whether you already had COVID-19 because:

• Research has not yet shown how long you are protected from getting COVID-19 again after you recover from COVID-19.
• Vaccination helps protect you even if you’ve already had COVID-19.

Yes. Your plan will cover diagnosis, testing, and treatment associated with COVID-19, including:

• COVID-19 diagnostic visits: Cigna is waiving out-of-pocket costs for COVID-19 diagnostic visits with in-network and out-of-network providers, whether at a provider’s office, urgent care center, emergency room, or via virtual care, through the Public Health Emergency (PHE) period.
• COVID-19 diagnostic testing: Cigna is waiving out-of-pocket costs for COVID-19 FDA-approved testing through the Public Health Emergency (PHE) period. Get more information on how to get tested at a center or at home.
• If you have gone out-of-network and received an unexpected bill for a COVID-19 diagnostic visit or test, Cigna's COVID-19 Customer Protection Program (CPP) can help. This COVID-19 assistance program helps resolve billing issues and is provided at no additional cost for eligible customers.² Call the phone number on your ID card and an advocate will help you.
• COVID-19 treatment: Cigna covers medical care for COVID-19 treatment subject to standard cost share, copay, and deductibles. Cigna covers the administration of all FDA emergency use approved (EUA) COVID-19 infusions consistent with EUA Guidelines and Cigna’s COVID-19 Drug and Biologic Therapeutics coverage policy.

*Diagnostic tests are covered for individuals with symptoms of a COVID-19 infection or who had exposure to someone with a suspected or confirmed COVID-19 infection, as well as for individuals before an elective hospital admission or procedure. Non-diagnostic and antibody tests are not covered by Cigna's standard coverage, but may be covered as required by state law. For more on testing, please download the Cigna testing brochure.

Check with your employee benefits administrator or human resources department. Many Cigna health plans do not cover testing for employment, travel, or school reasons.

Cigna does cover testing for diagnostic purposes when submitted by a laboratory and will waive cost-share for these tests through the end of the PHE period. Diagnostic purpose tests are those needed to make a diagnosis and manage your health and treatment plan.

Yes. In late December 2021, the U.S. Food and Drug Administration (FDA) approved two oral prescription medications for the treatment of coronavirus disease (COVID-19): PAXLOVID^TM (from Pfizer) and molnupiravir (from Merck).³ These medications can help lessen the virus’ effects and lower the risk of hospitalization. If your doctor thinks PAXLOVID or molnupiravir is right for you, you should take it as soon as you develop symptoms and test positive for COVID-19. Learn more about how to protect yourself and others from COVID-19

Yes. PAXLOVID and molnupiravir are available on Cigna’s prescription drug list as preferred brand medications.⁴ If you or a covered family member get a prescription for PAXLOVID or molnupiravir, you can fill it at any pharmacy (in- or out-of-network) that has it available. Or, you can get the medication directly from your doctor’s office (if they have it). Learn more about how to protect yourself and others from COVID-19

If you are in a position where you can choose your healthcare provider (e.g. non-emergency), we recommend using the provider directory available on myCigna.com or the myCigna^® mobile app to find an in-network provider. You can also call the phone number on your ID card to find in-network health care providers to eliminate any risk your provider may choose to bill above these rates.

Some people suffer from ongoing or new symptoms after a diagnosis of COVID-19. Recovery could take as long as or longer than three months. It is important to see your Primary Care Provider (PCP) to discuss ongoing COVID-19 symptoms and an appropriate treatment plan. If you don’t have a PCP, log in to myCigna and use the provider directory to find an in-network provider. For more information, visit Post-COVID Conditions | CDC

After you recover from COVID-19 and/or return home from a hospitalization, your PCP can determine the best treatment plan, including assessing any follow care needed. Continue to take ensure you are up to date with preventative care screenings.

The FDA recently authorized the monoclonal antibody therapy, REGEN-COV^TM, for emergency use as post-exposure prevention of COVID-19 for those 12 years of age and older weighing at least 88 pounds who are at high risk for progression to severe COVID-19, including hospitalization or death.

REGEN-COV also remains authorized for the treatment of mild-to-moderate COVID-19 for those who are at high-risk for progression to severe COVID-19. Your PCP is the best person to discuss whether this therapy is appropriate for you.

To find locations that may be able to provide monoclonal antibody therapeutic treatments visit:

The U.S. Department of Health and Human Services (HHS) outpatient antibody treatment locator tool

The National Infusion Center Association^SM