Medicare does not cover home COVID testing. Where can you get one for free?

key takeaways

  • Medicare beneficiaries cannot be reimbursed for COVID-19 testing at home because the plan is prohibited from covering self-administered diagnostic tests.
  • Medicare only pays for COVID tests ordered by healthcare professionals.
  • People covered by Medicare can order free at-home COVID tests from the government or visit a pharmacy testing site.

Private health insurers are now required to pay or reimburse up to eight home COVID-19 tests per person per month. While Medicaid plans can also cover state home testing, Medicare does not.

Medicare is a federal program that provides health care payers coverage for people 65 and older and young adults with permanent kidney failure. This population is also at high risk for severe illness from COVID-19, but coverage gaps in Medicare have prevented reimbursement for over-the-counter diagnostic tests. Providing coverage for home COVID-19 testing would require rewriting Medicare’s rules.

But Medicare is aware of the problem. According to a CMS spokesperson, the Centers for Medicare and Medicaid Services (CMS) is looking for ways to allow beneficiaries to quickly take COVID-19 antigen tests at home.

“While Original Medicare does not pay for over-the-counter home COVID-19 tests at this time, CMS is exploring ways Medicare can cover these tests as we look to overcome some statutory and regulatory hurdles,” the spokesperson said in an email. VigorTip was told in the email.

Dr. Adam E. Block, an assistant professor of public health at the New York School of Medicine, said overcoming the coverage gap wouldn’t be that complicated if health authorities wanted to address the problem.

For example, until March 2020, Medicare did not cover telehealth visits, but because of the pandemic, the rules changed, Bullock said.

Medicare Advantage plans may cover COVID-19 testing

Medicare will pay for a COVID-19 PCR or rapid test when ordered by a healthcare professional and performed by a laboratory. Currently, Medicare beneficiaries can get one free lab-performed test per year, no subscription required.

However, Medicare Advantage plans offered by private insurers under federal contracts may cover home testing, said David Allen, director of communications and public affairs for the health insurance industry trade group AHIP.

“Every American should be able to get the COVID-19 tests they need, and health insurance providers have covered the full cost of medically necessary COVID-19 tests from the start,” Allen said in an email Tell VigorTip.

“For many seniors with Medicare Advantage, health insurance providers have sent a clinician to their home for testing to protect them from the additional risk of infection,” he added.

Best Medicare Advantage Plan Providers in 2022

How to get a free home test kit

If you have symptoms of COVID-19 or have been exposed to someone with COVID-19, you should get tested three to five days after exposure.

If you have Medicare, there are other ways to get test kits for free. You can apply for free home testing at covidtests.gov.

The Department of Health and Human Services (HHS) is working to provide 50 million free at-home tests to community health centers and Medicare-certified clinics. The government has also set up more than 10,000 pharmacy testing sites that can provide testing for free regardless of your insurance coverage. You can find a testing location near you on the HHS website here.

what does this mean to you

Unlike people with private insurance or Medicaid, Medicare beneficiaries cannot be reimbursed for COVID-19 testing at home because the plan is prohibited from covering self-administered diagnostic tests. But in the meantime, there are other ways to get a free COVID test at home, such as ordering from covidtests.gov or finding a pharmacy testing site here.

The information in this article is current as of the date listed, which means that you may have updated information as you read this article. For the latest updates on COVID-19, visit our Coronavirus news page.