At home covid test cost reimbursement-what is correct?

At home covid test cost reimbursement-what is correct?

TLDR at bottom. NY, NY.

Trying to take advantage of the at home covid tests covered by insurance deal, I went to my local (in network) CVS pharmacy counter to inquire about getting 2 kits for myself (2 tests per kit for a total of 4 tests). They said they weren’t doing them at the pharmacy yet, I had to go purchase them myself at the front register. Note this was on Jan 28, after the effective date of Jan 15.

According to the gov’t requirement and my insurance company website, it is fine to purchase them myself and submit for reimbursement. Prior to purchasing, I went on my insurance website, selected my plan, and followed the only information provided “Members are covered for two test kits per week (one kit may contain two tests). Make sure to keep your receipt. Only FDA-authorized OTC at-home COVID-19 tests are covered.”

I follow that link which brings me to a FDA website, search for Binax, and the one they have at CVS comes up on the list (BinaxNOW COVID-19 Antigen Self Test as authorized for Home, H, M, W) so I am now assuming that means these tests are ok to buy and eligible for reimbursement. I needed them so I bought 2 Binax kits (2 test per kit) for $24 each, $48 total.

Now when I tried to submit the receipt for reimbursement to the insurance co, I am redirected to a rep at CVS caremark (pharmacy benefits) who tells me “oh no, you can only get reimbursement for Flowflex or Inteliswab brands and you only get $12 per kit” which also contradicts what is printed on the FAQ section of the CVS page.

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So friends, which info takes precedence? That which is listed online or what the rep says on the phone?

tldr; Bought 2 at home covid test kits out of pocket per the instructions of my insurance company. Now being told that it is a pharmacy benefit and CVS caremark only covers 2 brands of test (not the extensive list of brands I was originally directed to) at $12 per kit, not per test. So I’m out $48. Is this worth an argument/appeal or no?