The Biden administration will now allow people enrolled in Medicare or Medicare Advantage to get over-the-counter COVID-19 tests for free. Previously, only those with private health insurance, and in some cases Medicaid, were able to get the at-home tests covered by their insurers.
Under the new initiative, which is set to start in early spring, Medicare will cover up to eight at-home COVID-19 tests per month, the Centers for Medicare and Medicaid Services said Thursday. The tests will be available at participating pharmacies and other entities, and will only apply to COVID-19 tests that have been approved or authorized by the US Food and Drug Administration (FDA).
The expansion of the initiative is an important development, according to Caitlin Donovan, senior director of public relations at the National Patient Advocate Foundation. Not only will it open up coverage of at-home COVID-19 tests the roughly 60 million Americans—the majority of whom are over 65, and others who are younger with disabilities—but it's also the first time Medicare has covered any at-home diagnostic test, Donovan tells Health.
Here's what you need about how to access these free at-home tests with Medicare—and what to do in the meantime, until the initiative is up and running this spring.
How does the Medicare at-home COVID-19 test coverage work?
Medicare coverage of at-home COVID-19 tests works a little differently than that of private health insurers. While people with private health insurance have the option of either submitting for reimbursement of COVID-19 test purchases, or finding a pharmacy that allows point-of-purchase coverage, Medicare enrollees will only be able to pick up their free at-home COVID-19 tests at participating pharmacies.
To facilitate this, Medicare will pay the participating pharmacies or retailers directly, allowing beneficiaries to pick up the tests at no cost. Though the list of pharmacies or other entities that will be able to provide the free tests is not yet available, the CMS says that information should be ready when the initiative is in place.
Giving Medicare beneficiaries the ability to pick up free tests directly—and thus, not have to pay for them out-of-pocket and submit for reimbursement—gets rid of one potential barrier to access. "Especially with Medicare, there are a lot of people [who are] retired or on limited income, so asking them to pay for multiple tests a month could be incompatible with their budget," says Donovan.
In the spring, the CMS says Medicare enrollees will be able to ask their local pharmacy or health care provider if they're participating in the at-home testing initiative. If they are, receiving a test should be as simple as showing your insurance card, and walking out of the store with an at-home test in hand.
How can Medicare beneficiaries get free at-home COVID-19 tests in the meantime?
While the new initiative won't be available to people with Medicare until the early spring, there are still ways for beneficiaries to get free at-home COVID-19 tests. The first option is to take advantage of the four free tests American households are entitled to by visiting COVIDTests.gov. With a few clicks (and some of your contact information) you can get tests sent to your home from the US government. Certain community health centers in your area may also offer free at-home tests, according to Donovan.
If you're in need of a COVID-19 test ASAP, the US Department of Health and Human Services (HHS) says low- or no-cost COVID-19 tests are available to everyone in the US at health centers and select pharmacies. Tests are also free when they're provided by a health care provider. To find a location near you, you can visit the HHS website and enter your home state—that should bring up a list of places providing free or low-cost tests. The CMS urges people to call 1-800-Medicare if they have any additional questions on where to find a free COVID-19 test.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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