Does Medicare cover COVID test kits & testing?

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Dear Connie,

I saw something on the news the other day that said Medicare wouldn’t cover my COVID test kits. I’ve found getting the free ones in the mail and free COVID testing at my local pharmacy convenient.

I’m wondering if what they’re saying is true. Will coverage for COVID be changing? Does Medicare cover COVID test kits and testing? 

Concerned about COVID coverage,
Brenda from Phoenix, Arizona

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Dear Brenda,

The Public Health Emergency for COVID-19 expires at the end of the day on May 11, 2023. You’re right to be concerned about whether your COVID test kits and testing will be covered for Medicare beneficiaries after that date.

Since you didn’t mention what type of Medicare plan you’re enrolled in, I’ll provide an answer for Original Medicare and Medicare Advantage plans. 

At-home test kits and laboratory testing are treated differently with Original Medicare. 

Original Medicare does not cover over-the-counter services and tests. The Centers for Medicare & Medicaid (CMS) made an exception during the COVID-19 public health emergency, but that ends May 11, 2023. The current access to over-the-counter COVID-19 tests will end then. 

Until May 11, 2023, or until supplies last, you can order four at-home COVID-19 tests through the United States Postal Service (USPS). Every household is eligible to request four free at-home COVID-⁠19 tests. 

Agent tip:

“Avoid surprise bills: After May 11, 2023 you should contact your plan provider to see what is covered and if there is cost-sharing.“

Until May 11, 2023, you can also get eight at-home COVID-19 tests covered per calendar month by Original Medicare Part B medical insurance. You also qualify if you are enrolled in a Medicare Advantage plan. 

Until the Public Health Emergency (PHE) ends, you can get over-the-counter COVID-19 tests at participating pharmacies and healthcare providers. You can check with your pharmacy or health care provider to see if they are participating. If they are, you can receive your tests, and your Medicare Part B insurance will be billed. When purchasing covered tests, you should present your red, white, and blue Medicare card.

If you’d like to continue receiving free at-home COVID-19 tests when the Public Health Emergency ends, you should check to see which Medicare Advantage plan offers this coverage benefit. A local licensed agent can help you discover which plan works for your health and budget by calling (623) 223-8884.

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I understand that you’re also concerned about laboratory testing once the Public Health Emergency ends. 

After May 11, 2023, if you’re enrolled in Original Medicare, you can continue to receive COVID-19 PCR and antigen tests. If you want a test without cost-sharing, it must be ordered by a physician or other health care professional (physician assistant or certain registered nurses), and a laboratory must perform the test.

If enrolled in a Medicare Advantage plan, you can also receive COVID-19 PCR and antigen tests covered by your plan. You should check with your Medicare Advantage plan to learn if there is cost-sharing. Cost sharing for COVID testing under Medicare Advantage plans may be changing. 

A local licensed agent can help you determine if there is a change to your plan benefits. Call (623) 223-8884 (TTY: 711) to speak with a Connie Health agent. 

We’re here to support you throughout your Medicare journey. If you have any additional coverage questions, please reach out. We’re here to help. 

Sources

CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19
Public Health Emergency.
Medicare Covers Over-the-Counter COVID-19 Tests.
Medicare & Coronavirus.
Place Your Order for Free At-Home COVID-19 Tests.

Frequently Asked Questions

Does Medicare cover COVID testing?

Yes, Original Medicare covers PCR and antigen COVID testing in a laboratory setting. 

However, there might be cost-sharing depending on where the test is performed. If it’s ordered by a physician, physician assistant, and certain registered nurses and performed in a lab, then it likely will be covered by Part B without cost-sharing. 

Original Medicare does not cover at-home or over-the-counter testing after the end of the COVID-19 Public Health Emergency.

You should check your coverage for laboratory PCR and antigen tests and at-home or over-the-counter testing to avoid surprise bills. There may be an increase in cost-sharing once the COVID Public Health Emergency has ended on May 11, 2023.

Does Medicare cover rapid COVID test?

Original Medicare covers up to eight monthly over-the-counter COVID tests from participating pharmacies and healthcare providers. This lasts until the COVID-19 Public Health Emergency ends on May 11, 2023. 

If you have Medicare Part A and B, Original Medicare Part B will cover over-the-counter tests. If enrolled in a Medicare Advantage plan, you’ll also get this benefit through your Orignal Medicare coverage. Your Medicare Advantage plan may cover additional tests, so you should check your plan.

To receive your free over-the-counter / at-home rapid antigen COVID tests, you may need to show your Original Medicare red, white, and blue card – even if you’re enrolled in a Medicare Advantage or Part D plan.

Does Medicare cover at home COVID test?

Yes, Medicare covers the at-home rapid antigen COVID test until the COVID-19 Public Health Emergency ends on May 11, 2023. After that, Original Medicare will not cover these tests and generally doesn’t cover over-the-counter testing. 

Some Medicare Advantage plans may continue offering this coverage, so you should check with your plan provider.