Needs Review Not Apprvd
Information and Resources for AlaskaCare Members
What AlaskaCare is Doing for You
In response to the COVID-19 national public health emergency, the Division of Retirement and Benefits has implemented temporary plan changes and suspensions in the AlaskaCare health plans. Please note, these temporary changes are the result of Federal and State health mandates, suspension orders, and other guidance. The Division's compliance with these various requirements is temporary in nature and does not create a vested benefit in relation to these changes. All temporary administrative changes will be automatically rescinded upon the expiration of relevant enabling documents.
The Division of Retirement and Benefits is monitoring the status of COVID-19 in Alaska and will continue to provide updates regarding the effective dates of the temporary changes when more information becomes available. The Division will provide members with as much advance notice of the end of the temporary changes as is administratively possible.
AlaskaCare Coverage of At-Home, Over-the-Counter (OTC) COVID-19 Tests
- Will AlaskaCare cover at-home, OTC COVID-19 tests?
Yes, effective January 15, 2022 and through the end of the national public health emergency, your AlaskaCare health plans pharmacy benefit will cover at-home, OTC, FDA-authorized COVID-19 tests, 8 per month per covered person. Depending on where you obtain them, you can either get your tests without having to pay anything up front, or you will be reimbursed up to $12 per test. The new coverage requirements apply to the AlaskaCare Employee plan, and though the AlaskaCare Retiree plan is exempted from these requirements, the Division is temporarily providing similar coverage for test kits to the Retiree plan to support members during the national public health emergency.*
- Where can I obtain a test kit at no cost?
Employee plan members can obtain FDA-authorized COVID-19 test kits at a Rite Aid Pharmacy, Sam’s Club Pharmacy, Walgreens, Kinney Drug, or Walmart Pharmacy. There will be no up-front cost and no requirement to submit for reimbursement. Simply go to the pharmacy counter, present your OptumRx pharmacy benefit ID card, and ask to have your OTC at-home COVID-19 test submitted to your plan for coverage.
If you purchase an OTC COVID-19 test from any other source, you will need to pay for the test up front, and the plan will reimburse you up to $12 per test. Keep your receipt and submit a claim to OptumRx for reimbursement.
- How much will I be reimbursed for an at-home OTC COVID-19 test if I purchase the test up-front and then submit a claim for reimbursement?
You can purchase an FDA-authorized, OTC COVID-19 test kit at other stores or online retailers. Keep your purchase receipt(s) to submit to OptumRx for reimbursement. You will be reimbursed for up to 8 tests per covered member, per month without a prescription. AlaskaCare will reimburse you up to $12 per covered test. You can submit an online claim form here .
- What if I already bought and paid for at-home OTC COVID-19 tests? Can I still get reimbursement for those?
The temporary expanded coverage for at-home OTC COVID-19 tests is effective January 15, 2022. If you purchased tests on or after January 15, 2022, you can submit your receipts to OptumRx for reimbursement.
- Is there a limit to how many tests will be covered?
Yes. Covered members can get up to 8 individual tests per month (e.g., a family of 4 would be eligible for 32 tests a month.) Note that tests may be packaged individually or with multiple tests in one package (for example, 2 tests packaged in one box counts as 2 tests).
- Does AlaskaCare cover OTC tests used for employment?
- How long will it take to receive reimbursement from AlaskaCare?
No later than 30 calendar days after the receipt of claim.
- When can I submit my claim?
You can submit your claim to OptumRx now for covered tests purchased on or after January 15, 2022. Please submit your claim within one year of your purchase date.
- What if I can’t find available testing kits?
Testing may also be available through non-network pharmacies, at community testing sites, at your school or your health care provider and at private testing sites. Visit the statewide Testing Site Locator .
We know testing is limited, but it remains a critical tool. Whether you take an at-home test or laboratory test, a positive test tells you if you have COVID-19.
- What if I purchased a test, but lost my receipt?
In order to process your claim correctly, OptumRx needs a proof of purchase receipt that shows what test you purchased, when you purchased it, how many tests you purchased, and what the price was. If you do not have a receipt, contact the place of purchase to see if they can provide you with a replacement.
The following temporary benefits are still in effect:
- Expanded Coverage of Telemedicine: AlaskaCare is making it easier for you to connect with your regular health care providers remotely during the COVID-19 public health emergency. Effective March 4, 2020, through the end of the public health disaster, the AlaskaCare employee and retiree health plans are temporarily expanding coverage of telemedicine services delivered by your regular providers in alignment with coverage temporarily expanded by Medicare. If you or your provider are unsure which telehealth services are eligible for coverage, please contact Aetna at (855) 784-8646 for more information.
- COBRA Suspension of Disenrollment: Worried about paying your premiums? We will work with you to help you keep your healthcare coverage.
- Effective April 1, 2020 in accordance with federal guidelines, AlaskaCare is temporarily suspending disenrollment for members continuing their coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) who fail to pay health benefit COBRA premiums timely. Please contact the Division to learn about your options. All missed premium payments are due in full 60 days following the termination of the national public health emergency per IRS regulations.
The following benefits are permanently available to all AlaskaCare retiree and active employee plan members:
- COVID-19 Testing: If you receive laboratory tests to diagnose or treat COVID-19, AlaskaCare is waiving your deductible and coinsurance. To qualify, your laboratory tests must be deemed medically necessary under the terms of the plan and they must be FDA-approved.
- COVID-19 Vaccines: The AlaskaCare health plan covers the cost for FDA approved COVID-19 vaccines, subject to recognized charge, under both the medical and pharmacy plans, at any authorized site of care. AlaskaCare members receive the vaccine at no cost.
*The preceding temporary administrative changes are prospective in nature and shall remain in effect until earlier of the date of: 1) the termination of the suspensions contained in the applicable COVID-19 Disaster Order of Suspension; 2) the termination of the Declaration of Public Health Disaster Emergency issued by Governor Mike Dunleavy; or 3) the national public health emergency is terminated by the Secretary of Health and Human Services; including any extensions or amendments thereof. The temporary administrative changes listed above are in response to a State of Alaska and federally recognized health emergency and do not provide a vested right to coverage for any individual. The Division of Retirement and Benefits retains the sole discretion to rescind or modify these temporary administrative changes depending on the circumstances.
The Department of Administration, Division of Retirement and Benefits, is proposing an amendment to the AlaskaCare Defined Benefit Retiree Health Plan.Read More
Information on the Alaska Supreme Court Decision - Metcalfe vs State of AlaskaRead More
Site Policies || © State of Alaska ||
© State of Alaska || || drb.alaska.gov