Medicare to Cover Over-the-counter COVID-19 Tests for Beneficiaries

The Centers for Medicare & Medicaid Services is developing an initiative that will provide free access to eight over-the-counter (OTC) COVID-19 tests per month for Medicare beneficiaries. The initiative will apply to individuals enrolled in both traditional Medicare and Medicare Advantage (MA) plans. The new initiative will result in tests approved by the U.S. Food and Drug Administration being available through eligible pharmacies and other participating entities with payment directly from Medicare. Until the initiative is implemented, which is anticipated in early spring, Medicare beneficiaries can access free tests through other channels, including:

  • Requesting four free OTC tests for home delivery at the government’s dedicated webpage.
  • Accessing COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. The Department of Health and Human Services provides a webpage to search for community-based testing sites.
  • Accessing PCR tests and antigen tests performed by a laboratory at no cost when the test is ordered by a physician, nonphysician practitioner, pharmacist or other authorized healthcare professional. In addition, Medicare beneficiaries can access one lab-performed test without an order, also without cost sharing, during the public health emergency.

MA plans may also offer coverage and payment for OTC COVID-19 tests as a supplemental benefit; MA beneficiaries should check with their plan on whether it includes this benefit. More information is provided in a frequently asked question document on the CMS website. Members with questions may contact Vickie Kunz at the MHA.