Do I need fasteners to install this?

Yes. The rail mounts at factory points but hardware is not included. You'll need bolts that match your OEM specification — grab what came out with your old rail or check your service manual for the correct size.

Will this work with an aftermarket bumper cover or does it need to be OEM?

This is a structural support rail, not a cover. It works with any front right bumper cover that uses factory mounting alignment — aftermarket or OEM both bolt on the same way.

Can I install this myself with basic hand tools?

Yes. You're unbolting the old rail and bolting on the new one at existing frame points. No drilling, no welding, no special equipment needed — just sockets and a jack to get under the front end safely.