COVID-19 testing and treatment


Assess your risk

You should get tested for COVID-19 if:

  • You are feeling sick and are experiencing symptoms of COVID-19, regardless or vaccination status or prior infection

  • You’ve had close contact to someone with suspected or confirmed COVID-19
    • Fully vaccinated people should be tested 3-5 days after exposure, and wear a mask in public indoor settings for 10 days or until they receive a negative test result
    • People who have tested positive for COVID-19 within the past 3 months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms

  • You are unvaccinated and have taken part in activities that put yourself at higher risk for COVID-19 because you cannot physically distance as needed to avoid exposure, such as travel, attending large social or mass gatherings, or being in crowded or poorly-ventilated indoor settings
  • You have been asked or referred to get tested by your healthcare provider, or state, tribal, local, or territorial health department


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 Tests

Providence members are now able to purchase over-the-counter (OTC) at-home COVID-19 tests, at little or no cost to you.

  • 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 every 30 days.
  • Providence Health Assurance (PHA) Medicare Advantage plan members: PHA will cover FDA-authorized OTC at-home COVID-19 diagnostic test 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 every 30 days.
  • Providence Health Assurance (PHA) Medicaid Plan Members: PHA will cover FDA-authorized OTC at-home COVID-19 diagnostic test purchased on or after March 11, 2021, without a doctor’s prescription. This benefit for OTC at-home COVID-19 test includes up to 4 tests per member every 30 days.

Self-testing kits (also referred to as at-home tests or over-the-counter (OTC) tests) are available at local pharmacies, local retailer or online retailer at no cost to members. OTC test kits should be used if you have symptoms of COVID-19 and you think you may have been exposed. If you don't have symptoms, you may receive a false result. If positive, you should seek a confirmatory PCR test from an authorized lab.

  • Every home in the U.S. is eligible to order 4 free 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.
  • Providence members who purchase an over the counter (OTC) FDA-authorized COVID-19 antigen testing kit at a retail location may be eligible for reimbursement. Reimbursement can be requested by attaching the FDA-authorized COVID-19 antigen testing kit receipt (or multiple receipts) and filling out the reimbursement form to send to Providence Health Plan at the address on the back of your ID card.
  • OTC COVID-19 test kits are available to members at $0 out-of-pocket cost through any participating pharmacy. The following OTC products are FDA-authorized and set-up to process at a participating pharmacy:
    • BinaxNow Antigen COVID-19 test
    • Carestart COVID-19 Antigen Home Test
    • On/Go™ COVID-19 Antigen Self-Test
    • Ellume COVID-19 home test
    • IHealth COVID-19 Antigen Rapid Test
    • Inteliswab COVID-19 Rapid Test
    • QuickVue At-home COVID-19 test


FAQ

  • Do I need a prescription to obtain a free at-home over-the-counter COVID-19 test?
    No, you do not need a prescription for the first eight over-the-counter (OTC) COVID-19 at-home tests to diagnose the presence of illness for coverage. Visit any participating 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.
  • Where can I buy an OTC test?
    OTC tests can be found at your local pharmacy counter, a retail location or online. If you visit an in-network pharmacy, it can bill your insurance directly at no cost to you. A list of in-network pharmacies can be found here.

    If you purchase an OTC 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.

    Retailers may have per-person limits due to high demand for tests and limited availability.
  • 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.


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 for COVID-19 for members who are not in the hospital

Treatment is not a substitute for vaccination against COVID-19. Vaccines are the best protection from COVID-19.

Certain COVID-19 treatment options such as monoclonal antibodies (mABs) and COVID-19 antiviral medications taken by mouth (Paxlovid and Molnupiravir) 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.

  • Members who are not hospitalized may qualify for monoclonal antibody treatment if they have COVID-19 with mild to moderate symptoms for 10 days or less and are at high risk for severe COVID-19.
  • Members who are not hospitalized may qualify for monoclonal antibody post-exposure prophylaxis therapy, therapy after one has been exposed to COVID-19, if they are a vulnerable person (not fully vaccinated or immunocompromised) and are at high risk for progression to severe COVID-19.

Paxlovid and Molnupiravir are the first two medications for COVID-19 authorized by the FDA to be taken by mouth for treatment of COVID-19 for patients who are not hospitalized. These 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.

If you recently tested positive for COVID-19 or were recently exposed to COVID-19, talk to your healthcare provider to see if monoclonal antibody treatment is right for you.

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



Find monoclonal antibody therapy for COVID-19

Members should first talk to their healthcare provider about monoclonal antibody therapy.

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).

  • 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.


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).

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