Update: The federal government announced April 4 that Medicare started covering over-the-counter tests. For details, see “Medicare Now Covers At-Home COVID-19 Tests.”
Seniors may be the most at risk for severe cases of COVID-19, but Medicare surprisingly does not cover the cost of at-home test kits.
This is despite that the federal government now requires private insurers to cover the cost of up to eight over-the-counter tests per individual per month.
The problem reportedly lies within the federal laws that outline what is covered by Original Medicare health insurance, Kaiser Health News reports. They don’t allow for coverage of self-administered diagnostic tests such as at-home COVID-19 tests.
Instead, Medicare beneficiaries have to rely on one of the following options if they want free COVID-19 tests.
Every household in the country is now entitled to request four free at-home COVID-19 tests from the federal government. These rapid antigen tests will be delivered by the U.S. Postal Service and provide results in 30 minutes.
To request your free tests, visit the official government website at COVIDtests.gov. Those without internet access can call 1-800-232-0233. Assistance is available to those with disabilities through the Disability Information and Access Line at 1-888-677-1199 or by emailing [email protected].
Community health centers and Medicare-certified clinics
While Medicare won’t pay for at-home tests directly, the federal government is setting aside 50 million over-the-counter COVID-19 tests to be distributed for free to patients of community health centers and Medicare-certified clinics. An email was sent to eligible clinics in December 2021 informing them of the registration and ordering process.
Since this is a voluntary program, not all clinics and health centers may be participating. However, if you get services from one of these sites, check to see if free COVID-19 tests are available for pick-up.
This isn’t an option everywhere, but some states and counties have launched programs to distribute free at-home COVID-19 tests at local libraries. The library systems of the state of Michigan, Montgomery County in Maryland and Maricopa County in Arizona are a few of the places trying this approach for test distribution.
Medicare Advantage plans
Medicare Advantage, also known as Medicare Part C, is the other type of Medicare coverage offered by numerous private health insurance companies. These plans must cover everything included in Original Medicare and typically have added benefits such as coverage for dental care or hearing aids.
While every plan has a different set of added benefits, some Medicare Advantage plans may pay for over-the-counter COVID-19 tests. The U.S. Department of Health and Human Services advises that people with Medicare Advantage contact their plan to find out if it covers at-home tests.
Health care professionals
If none of the at-home options work for you — or if you use up the free tests you were given — Medicare will pay for COVID-19 tests that are obtained in person from a doctor, hospital, pharmacy or laboratory and that are ordered by a doctor or other health care professional. Check with your health care provider’s office for details on how to make an appointment.
Community-based testing sites
Another option for in-person testing is a community-based site. The federal government has partnered with pharmacies such as CVS Health, Walgreens and Rite Aid to offer more than 10,000 free testing locations nationwide. Many independent pharmacies and Walmart locations are participating as well.
What’s more, community health centers offer services to those who meet COVID-19 testing criteria, regardless of their ability to pay. You can search online for a health center near you.
For more on COVID-19 testing, check out: