February 4, 2022
Biden-Harris Administration Will Cover Free Over-the-Counter COVID-19 Tests Through Medicare
CMS Developing Initiative to Enable Access to Eight Free Over-the-Counter COVID-19 Tests
for Medicare Beneficiaries in Early Spring. As part of the Biden-Harris Administration’s ongoing efforts to expand Americans’ access to free testing, people in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. Under the new initiative,
Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per
month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA).
This is the first time that Medicare has covered an over-the-counter test at no cost to
beneficiaries. There are a number of issues that have made it difficult to cover and pay for over-the-counter COVID-19 tests. However, given the importance of expanding access to testing,
CMS has identified a pathway that will expand access to free over-the-counter testing for
Medicare beneficiaries. This new initiative will enable payment from Medicare directly to
participating pharmacies and other participating entities to allow Medicare beneficiaries to pick
up tests at no cost. CMS anticipates that this option will be available to people with Medicare in
the early spring.
Until then, people with Medicare can access free tests through a number of channels established by the Biden-Harris Administration. Medicare beneficiaries can:
• Request four free over-the-counter tests for home delivery at covidtests.gov.
• Access COVID-19 tests through healthcare providers at over 20,000 free testing sites
nationwide. A list of community-based testing sites can be found here.
• Access lab-based PCR tests and antigen tests performed by a laboratory when the test is
ordered by a physician, non-physician practitioner, pharmacist, or other authorized health
care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a
health care professional, people with Medicare can also already access one lab-performed
test without an order, also without cost sharing, during the public health emergency.
In addition:
• Medicare Advantage plans may offer coverage and payment for over-the-counter
COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and
Part B benefits, so Medicare beneficiaries covered by Medicare Advantage should check
with their plan to see if it includes such a benefit.
• All Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled
in a Medicare Advantage plan or not.
For more information, please see link below.
https://www.cms.gov/newsroom/news-alert/biden-harris-administration-will-cover-free-over-counter-covid-19-tests-through-medicare
SOURCE: Center for Medicare and Medicaid Services