Updated: September 1, 2022
Find Testing Near You
Health Centers: Federally qualified health centers are an important part of the national response to the COVID-19 pandemic. Find a health center near you for available COVID-19 screening and testing. Please call the health center for more information about availability of low or no-cost testing. Additional testing sites may be available in your area. Contact your health care provider or your state or local public health department for more information.
Pharmacy Testing Sites: The Department of Health and Human Services (HHS) has established more than 10,000 free community-based pharmacy testing sites around the country. To respond to the omicron variant surge, HHS and the Federal Emergency Management Agency (FEMA) are creating surge testing sites in states across the nation. Find a pharmacy testing site near you for available COVID-19 screening and testing.
At-Home Tests:
Commercial plan members (either through group or individual coverage) are able to be reimbursed by CommunityCare for over-the-counter tests purchased through mail, retail, or online. Reimbursement for tests is limited to the actual cost of the test or $12 per test, whichever is less.
CommunityCare has made arrangements for you to be able to get over-the-counter COVID-19 home test kits through our usual retail pharmacy network. This means you can go to the pharmacy counter of your local pharmacy and receive test kits, usually without any out-of-pocket costs. If you are charged for the test kits, you will be reimbursed as noted above.
The monthly eight-test limit per covered individual is measured by test, so if a testing kit has two tests per package, the limit would be four packages. Provider ordered tests do not count toward the monthly limit.
The guidance clearly identifies that it does not impact previous guidance indicating plans are not required to cover the cost of surveillance testing, tests for return to work screening or other employment-related purposes.
The guidance also allows health plans to continue fraud, waste, and abuse mitigation programs and permits plans to require a patient attestation as to the purpose of the test.
CommunityCare members may contact CommunityCare customer service at (918) 594-5242 with any questions.
For Medicare Advantage Members
CommunityCare is offering free at-home COVID-19 tests to Senior Health Plan members while supplies last. Tests are available at the CommunityCare Senior Center (4720 S. Harvard) and at the CommunityCare office at 2 W. 2nd Street (visit the CommunityCare reception desk). Members may want to call the Senior Center in advance to verify availability of tests at (918) 594-4118. Tests are limited to two per person. Please show your CommunityCare member ID to pick up the free tests.
- Medicare is directing members to pick up free at-home tests from community health centers and Medicare-certified health clinics. A listing of locations
- Medicare Advantage members are also encouraged to participate in the free at-home tests being offered by the government as mentioned above.
- All COVID-19 testing comes with a $0 copay when ordered by your physician. Medicare Advantage members are able to be reimbursed by CommunityCare for up to eight over-the-counter tests per month purchased through mail, retail, or online. Reimbursement for tests is limited to the actual cost of the test or $12 per test, whichever is less.
COVID-19 treatment
Member cost share including copays, coinsurance and deductibles will be applied in accordance with your benefit plan for treatment related to COVID-19.
Telemedicine services
Effective January 1, 2022, CommunityCare adopted standard Telemedicine benefits as required under the Oklahoma Telehealth Parity Law for all commercial plans excluding Grandfather and Transitional (aka Grandmother) plans.
For Services that can be performed via Telemedicine the cost-share will be the same as if the service was provided at non-Telemedicine location. (Example: A Primary Care office location visit and a Primary Care telehealth visit will have the same copay applied.)
Medicare Advantage plans will follow Centers for Medicare & Medicaid Services (CMS) guidelines and list of services eligible for Telemedicine.
If you have questions, please contact your provider relations representative or the Provider Connection Line at (918) 594-5207 or (877) 321-0018.
Prior authorization
Prior authorization will not be required for any COVID-19 testing or COVID-19 disease treatment, such as outpatient or inpatient therapeutics or COVID-19 related prescription medications. Prior authorization will be required for facility admissions.
Prescription refills
Early refills of maintenance medications from the pharmacy will also be covered, and longer fills up to 90 days for employer group members and many medications up to 100 days for our Medicare Advantage members are available.
Contact us
Members may contact CommunityCare customer service at (918) 594-5242 for questions about coverage or information on how to access telemedicine services and what will be required for reimbursement.
Helpful resources to keep you informed
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