Insurance coverage information for HealthPartners members

If you have HealthPartners insurance, we understand you may have questions about coverage for COVID-19 testing, treatment or vaccines. Here you can find our latest health plan information for COVID-19.

Have questions about your specific situation? Call Member Services at the number on the back of your member ID card. We’re here to help.

Rapid COVID-19 diagnostic testing at home

Your coverage for rapid COVID-19 testing at home may vary depending on what kind of plan you have.

With a prescription, each eligible plan member has coverage for up to eight at-home diagnostic test packages per month.

  • Members of the following MHCP plans have this coverage:
    • HealthPartners® Prepaid Medical Assistance Program (PMAP)
    • HealthPartners® MinnesotaCare
    • HealthPartners® Inspire (SNBC)
    • HealthPartners® Minnesota Senior Care Plus (MSC+)
    • HealthPartners® Minnesota Senior Health Options (MSHO) (HMO SNP)
  • Test packages must have received an Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) to be eligible for coverage. All antigen diagnostic tests and molecular diagnostic tests with an FDA-issued EUA are covered.

To use your at-home testing coverage, bring your prescription to a durable medical equipment (DME) provider in your network.

  • Many pharmacies in your network are also DME providers. But you can also call your preferred pharmacy to find out if they’re participating.
    • Please note that CVS, Walgreens, Publix and Kroger are not participating providers. We cannot reimburse you if you purchase test packages at these locations.
  • You must present your prescription for your coverage to be applied. When you do, the pharmacy or DME provider will bill your HealthPartners insurance, and you won’t have any out-of-pocket costs.
  • You cannot get reimbursed for test packages you pay for out of pocket. MHCP rules prevent HealthPartners from paying members directly for covered services.

If you have questions about your coverage or how to use it, call Member Services at 866-885-8880 (TTY 711).

Each eligible Medicare beneficiary has coverage for up to eight at-home diagnostic tests per calendar month.

  • Beneficiaries who have Medicare Part B (including HealthPartners members enrolled in any Medicare Advantage, Medicare Cost or Medicare Supplement plan) have this coverage.

To use your at-home testing coverage, bring your red, white and blue Medicare card to a participating pharmacy. You can find a partial list of participating pharmacies at medicare.gov, but you can also call your preferred pharmacy to find out if they’re participating

  • You must present your red, white and blue Medicare card to use your coverage, not your HealthPartners member ID card. Your at-home test coverage is through Medicare, not HealthPartners.
  • You can’t get reimbursed for tests you pay for out of pocket. When purchasing tests, make sure your pharmacy has the right information so it can bill Medicare and not you.
  • A “test” refers to a single nose or throat swab – if a test box contains multiple swabs, each swab is counted separately.
  • Tests must have received an Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) to be eligible for coverage. All antigen diagnostic tests and molecular diagnostic tests with an FDA-issued EUA are covered.

If you have questions about your coverage or how to use it, call Member Services.

Each eligible plan member has coverage for up to eight at-home diagnostic tests per month, at up to $12 per test.

  • Coverage is available for:
    • Fully insured employer plan members
    • Self-insured employer plan members who have pharmacy benefits through HealthPartners
    • Individual and family plan members
    • Retiree National Choice (RNC) plan members
  • A “test” refers to a single nose or throat swab – if a test box contains multiple swabs, each swab is counted separately.
  • Tests must have received an Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) to be eligible for coverage. All antigen diagnostic tests and molecular diagnostic tests with an FDA-issued EUA are covered.

To use your at-home testing coverage, we recommend buying tests directly from a pharmacy in your plan’s network. When you buy tests from an in-network pharmacy, you’ll pay little or nothing out of pocket.

  • You must buy tests at the pharmacy counter (where prescriptions are filled) for your coverage to be applied automatically. You’ll be asked for your insurance information, and your coverage will be processed just like when you get a prescription.
    • If you don’t buy tests at the pharmacy counter, you may have to pay out of pocket, but you’ll be able to request reimbursement separately. Save your receipts and test boxes.
    • Please note that CVS and Walgreens are in network pharmacies but do not accept your insurance for COVID-19 tests. If your purchase tests at these locations, you’ll have to pay out of pocket, but you can still request reimbursement.
  • You can also get tests shipped directly to your doorstep via our mail-order pharmacy partner, WellDyne.

If you paid for tests out of pocket, you can request reimbursement by signing into your online account. Once you sign in, follow the prompts to fill out your reimbursement request.

  • Only policyholders on eligible plans can request reimbursement online. Policyholders can request reimbursement for tests purchased and used by any plan member.
  • Receipts documenting test purchases – as well as test box barcodes – are required to receive reimbursement.
  • You’ll receive a check for your approved reimbursement amount within two to four weeks. We’ll mail your check to the policyholder’s address we have on file.
  • If you don’t have an online account, it’s easy to create one to submit your reimbursement request. But you can also submit your request by filling out a paper form – call Member Services at the number on the back of your member ID card to request this form. Paper forms may take us longer to process.

Please note that not all at-home diagnostic tests may be covered. Examples include tests solely for travel or employment purposes, tests not considered medically necessary, and non-rapid at-home tests.

COVID-19 diagnostic testing performed in a clinic

Your coverage for COVID-19 diagnostic testing performed in a clinic may vary depending on what kind of plan you have.

MHCP plan members have 100% coverage for COVID-19 diagnostic tests that are:

  1. Performed by a doctor or appropriately licensed provider in a clinical setting, AND
  2. On the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) list or a state-approved test list

Members of the following MHCP plans have this coverage:

  • HealthPartners® Prepaid Medical Assistance Program (PMAP)
  • HealthPartners® MinnesotaCare
  • HealthPartners® Inspire (SNBC)
  • HealthPartners® Minnesota Senior Care Plus (MSC+)
  • HealthPartners® Minnesota Senior Health Options (MSHO) (HMO SNP)

We strongly recommend seeking testing at in-network locations, when possible. This makes it faster and easier to pay your costs.

Most HealthPartners members have 100% coverage for COVID-19 diagnostic tests that are:

  1. Performed by a doctor or appropriately licensed provider in a clinical setting, AND
  2. For medically necessary purposes, AND
  3. On the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) list or a state-approved test list

Medically necessary diagnostic tests include tests for people experiencing symptoms of COVID-19 as well as tests for asymptomatic people who may have had close contact with COVID-19.

Examples of diagnostic tests that may not be covered include tests solely for travel or employment purposes as well as other tests not considered medically necessary.

We strongly recommend seeking testing at in-network locations, when possible. This makes it faster and easier to pay your costs.

How to submit an out-of-network COVID-19 testing claim (PDF)

COVID-19 antibody (serology) testing

Antibody (serology) tests are used to determine if a person has previously had, and recovered, from COVID-19. Tests are done by testing a sample of a person’s blood.

During the COVID-19 pandemic, HealthPartners covers all COVID-19 antibody tests that are:

  1. Ordered by a doctor or appropriately licensed provider, AND
  2. For medically necessary purposes, AND
  3. On the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) list or a state-approved test list

For all members, including MHCP plan members (Medical Assistance/Medicaid), HealthPartners covers the full cost of antibody testing that meets the above guidelines.

It’s important that antibody tests be ordered by a doctor or other appropriately licensed provider. If you order a test on your own, it may not be covered.

E-care, phone and video visits related to COVID-19 testing

All e-care, phone and video visits associated with COVID-19 testing are covered, including visits at Virtuwell, Doctor on Demand, Teladoc and other e-care providers.

If COVID-19 testing is not performed, these visits are subject to your standard coverage.

COVID-19 vaccine coverage

The cost of COVID-19 vaccines is covered 100% – with no cost sharing (copays, deductibles, etc.) – for all HealthPartners members, including MHCP plan members (Medical Assistance/Medicaid).

In addition, Medicare is covering the cost for most Medicare beneficiaries, including HealthPartners® Minnesota Senior Health Options (MSHO) (HMO SNP) members.

All forms of the vaccine are covered – including booster shots and immunocompromised doses. Neither the type of vaccine nor the dosage affects your coverage.

COVID-19 treatment coverage

In the majority of COVID-19 cases, people are directed to self-care, self-quarantine, and contact their doctor or provider as needed. Most people recover from COVID-19 without needing additional medical treatment.

If you do need acute medical care directly related to your diagnosis of COVID-19, it’s covered. Your cost-sharing amount depends on which kind of plan you have:

  • Fully insured employer plan, individual and family plan, and Medicare plan members – Your plan’s standard cost-sharing amounts apply.
  • MHCP plan members ­(Medical Assistance/Medicaid) – Cost-sharing amounts related to acute COVID-19 treatment, including hospital admissions, are waived until the federal and state governments end the public health emergency.
  • Self-insured employer plan members – For most plans, your plan’s standard cost-sharing amounts apply. Please call Member Services at the number on the back of your member ID card to understand your specific plan’s acute COVID-19 treatment coverage.

(Please note that any applicable cost-sharing waivers do not apply to care for ongoing complications after an acute COVID-19 infection has passed. For this kind of ongoing care, your standard coverage and cost-sharing amounts apply.)

COVID-19 virtual visit coverage

Virtual visits for services not related to COVID-19 testing and diagnosis follow the member’s regular plan coverage and cost sharing.

For example, a virtual office visit for an illness will be covered under your Office Visit for Illness or Injury benefit, just like an in-person visit would be. This includes virtual visits for physical therapy, speech therapy and occupational therapy.

To review your plan coverage, sign in to your HealthPartners account or call the Member Services number on the back of your member ID card.