You can be reimbursed (paid back) for both:
Medi-Cal members: Do NOT use this page for test reimbursement. Visit the California Department of Health Care Service (DHCS) for reimbursement and coverage information. Visit the Medi-Cal website for more details.
Over the counter (OTC) at-home tests
All OTC at-home tests ordered by a healthcare provider are covered. If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. OTC test are allowed to limit reimbursement of each test to $12. This currently does not apply to Medicare Advantage members.
Online claims
When filing claims online, you must use a separate claim form for each receipt and for each member. (To submit a single form for multiple members and/or receipts, use a mail-in form instead. See below.)
Online claim example 1: Let’s say you made a one-time purchase of up to 24 tests for three members. In this case, you should fill out three claim forms – one for each member. With each claim form, you should include the same receipt.
Online claim example 2: If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms.
Mail-in claims
Mail-in claim forms allow you to submit a claim for multiple members with one form. You can also include multiple receipts with one form.
If you purchased an OTC at-home test at the direction of your health care provider, please use this form:
If you purchased an OTC at-home test for any other reason, please use this form:
Send a copy of all your receipt(s) with the form. If you need more space to include additional members, receipts, or healthcare providers, you may use a separate sheet of paper. However, you must include all required information requested in the form.
Mail your completed claim form with a copy of your receipt(s) to:
Blue Shield of California
PO Box 272540
Chico, CA 95927-2540
COVID-19 laboratory tests (PCR tests)
If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim.
- Log in to blueshieldca.com (Engagement Point users at engagementpoint.com)
- Choose “Claims”
- Select “File a claim”
- Locate on your invoice:
- healthcare provider’s Tax ID
- procedure code
- diagnosis code
- Enter that information as indicated. If any information is missing from the invoice, contact the provider
Last updated: 11/10/2023
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