Over-the-counter COVID-19 Tests Covered for Medicare Beneficiaries

The Biden-Harris Administration recently announced that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. Medicare recipients may receive up to eight tests a month from participating pharmacies and health care providers during this healthcare emergency.

According to a press release from the Centers of Medicare and Medicaid Services, HHS Secretary Xavier Becerra said they were expanding access to free over-the counter COVID-19 testing for those who are receiving Medicare Part B, including those enrolled in a Medicare Advantage Plan.

“People with Medicare Part B will now have access to up to eight FDA-approved, authorized or cleared over-the-counter COVID-19 tests per month at no cost. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests free of charge,” she said. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also delivering close to 250 million at-home, rapid tests to send for free to Americans who need them. Under the Biden-Harris Administration’s leadership, we required state Medicaid programs, insurers and group health plans to make tests free for millions of Americans. With today’s step, we are further expanding health insurance coverage of free over-the-counter tests to Medicare beneficiaries, including our nation’s elderly and people with disabilities.”

This is the first time that Medicare has covered an over-the-counter self-administered test at no cost to beneficiaries, according to CMS.

“This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the two sets of four free at-home COVID-19 tests Americans can continue to order from covidtests.gov. National pharmacy chains are participating in this initiative.”

Testing remains a critical tool in mitigating the spread of COVID-19, and CMS is committed to making sure people with Medicare have the tools they need to stay safe and healthy, said Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure.

“By launching this initiative, the Biden-Harris Administration continues to demonstrate that we are doing everything possible to make over-the-counter COVID-19 testing free and accessible for millions more Americans.”

Providers and suppliers eligible to participate include certain types of pharmacies and other health care providers who are enrolled in Medicare and able to furnish ambulatory health care services such as preventive vaccines, COVID-19 testing and regular medical visits, according to the release from CMS.

“To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes. If a health care provider currently provides ambulatory health care services such as vaccines, lab tests or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.”

Deputy Administrator Dr. Meena Seshamani, Director of the Center for Medicare at CMS, said the tests are being paid for as a response to the pandemic.

“Combined with the free over-the-counter tests available through covidtests.gov, this initiative will significantly increase testing access for Americans most vulnerable to COVID-19 and will provide valuable information for future payment policy supporting accessible, comprehensive, person-centered health care,” she said.

For a list of eligible pharmacies and other health care providers that have committed publicly to participate in this initiative, click here. Because additional eligible pharmacies and health care providers may also participate, those with Medicare should check with their pharmacy or health care provider to find out whether they are participating. 

For more information, please see this fact sheet https://www.cms.gov/newsroom/fact-sheets/medicare-covers-over-counter-covid-19-tests