COVID-19

eternalHealth offers our members eight over-the-counter COVID-19 tests at no cost to them!
COVID

What You Should Know

  • eternalHealth members will be able to get up to 8 over-the-counter COVID-19 home tests per calendar month at no additional cost to them ($0).
  • Below are the following ways a member can access this benefit.
    • Option 1: Go to any in-network pharmacy, which can be found here, and show your eternalHealth Member ID at the pharmacy counter to get the COVID-19 test kit reimbursed at point-of-sale, similarly to how you would for any prescription medication. If for any reason, an in-network pharmacy is unable to process your covid test kits or if you forget to show your eternalHealth Member ID at checkout, please use the process outlined above in ‘Option 2’, and submit a DMR form, along with a copy of the receipt.
    • Option 2: If you purchase a COVID-19 test kit at any retail location or online (ex. Amazon, etc.), you can submit a copy of your receipt along with a Direct Member Reimbursement (DMR) form to get reimbursed up to $12 per individual kit. You can find the DMR form here, please submit it to the address listed on top of the form or onto your pharmacy member portal and you will be reimbursed within 30 days.
  • No prescription is required to obtain COVID-19 test kits.
  • No cost of test kits will be applied towards your pharmacy deductibles or out-of-pocket plan benefit limits.
  • No additional utilization management edits will be applied.
  • If you have any questions at all, please feel free to contact eternalHealth’s Customer Service Representatives at 800-891-6989 (TTY 711).

*We are available 8am – 8pm EST, 7 days a week 

October 1st – March 31st, April 1st – September 30th

*Monday – Friday 8am – 8pm
*Saturdays 10am – 2pm

  • Select a product from our list (shown below).
    • Maximum reimbursement of up to $12 per individual test kit.
    • Maximum of 8 individual test kits per calendar month per member.
  • As a reminder, if you are submitting a paper direct member reimbursement form, please save your receipt(s) so that you can submit a copy along with the form.

Covered Products

As of February 3, 2022
NDCProduct Name/Label
11877001133BINAXNOW COVID-19 AG CARD HOME TEST
11877001140BINAXNOW COVID-19 AG SELF TEST
50010022431CARESTART COVID-19 AG HOME TEST
50010022432CARESTART COVID-19 AG HOME TEST
50010022433CARESTART COVID-19 AG HOME TEST
56964000000ELLUME COVID-19 HOME TEST
51044000842EVERLYWELL COVID-19 HOME COLLECT
82607066026FLOWFLEX COVID-19 AG HOME TEST
82607066027FLOWFLEX COVID-19 AG HOME TEST
82607066028FLOWFLEX COVID-19 AG HOME TEST
82607066047FLOWFLEX COVID-19 AG HOME TEST
56362000589IHEALTH COVID-19 AG RAPID TEST
56362000590IHEALTH COVID-19 AG RAPID TEST
56362000596IHEALTH COVID-19 AG RAPID TEST
08337000158INTELISWAB COVID-19 RAPID TEST
00042022224PIXEL COVID-19 HOME COLLECTION KIT
14613033967QUICKVUE AT-HOME COVID-19 TEST
14613033968QUICKVUE AT-HOME COVID-19 TEST

Reimbursement

Want to get your COVID-19 test kit reimbursed?

If you were billed for your COVID-19 test kit, complete this form, and attach the original receipt for each COVID-19 test kit to get reimbursed.
Download and complete the form, then mail it to:

OptumRx Claims Department
PO Box 650334
Dallas, TX 75265-0334
covid 2
Page Last Updated On: February 13, 2023
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Tom Cunniffe

Tom Cunniffe

Director of Operations 

Tom Cunniffe comes to eternalHealth with over 20 years of healthcare operations’ experience, having held leadership positions in Call Center, Enrollment, Credentialing, UAT and Reimbursement teams. Tom has worked with Medicaid, Commercial and Medicare lines of business and has consistently built teams who are metrics driven with proven successful outcomes. Making sure our business strives for an efficient, best-in-class customer experience is at the center of Tom’s philosophy.

Tom has a bachelor’s degree from Fordham University and a master’s in business administration from University of Massachusetts at Amherst.

Tom Lawless

Tom Lawless

Chief Financial Officer

Tom Lawless has spent the past 20+ years building, sustaining, and growing new healthcare-related programs that balance fiscal responsibility & prudence with creativity & innovation, focusing on models of care that are novel, person-centered, and improve the social welfare of those who are served. He is very excited to continue doing so in his role as the Chief Financial Officer of eternalHealth.

Tom comes to eternalHealth from a not-for-profit, member-centric, health insurance cooperative. He helped the company continuously strive toward its dual goals of thriving financially, while keeping members at the very epicenter of its mission and service model. While there, Tom also spearheaded the creation of a brand new private, charitable foundation, which will be meaningfully giving back to those in need in the surrounding communities for years to come. Previously, Tom worked in the finance department of a successful hospice that provided high-quality care to persons experiencing their unique and poignant end-of-life journeys, assuring that the appropriate financing was always available. Tom’s career began as a civil servant in the Wisconsin Medicaid program, where he helped to create a program that expanded the institutional entitlement to care into home and community-based settings. Starting with only a blueprint in hand, the program now serves more than 57,000 frail elders and disabled adults and is considered a national model. Growing into a senior leadership role, Tom was a key architect of an innovative financing model, through which the public and private sectors successfully collaborated to better the lives of persons in great need.

Tom holds undergraduate and graduate degrees from the University of Chicago, with additional graduate work in economics completed at the University Wisconsin-Madison.

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