Medicare to pay for at-home COVID-19 tests this spring

Medicare will soon start to pay for at-home COVID-19 tests, allowing beneficiaries to have the same access to free over-the-counter tests as people with private insurance.

The Centers for Medicare and Medicaid Services on Thursday announced a new initiative that will allow Medicare beneficiaries and people with Medicare Advantage plans to access up to eight over-the-counter COVID-19 tests per month for free at participating pharmacies and retailers, beginning “in the early spring.”

Medicare will directly reimburse participating pharmacies and other retailers, allowing Medicare beneficiaries to pick up tests at no cost. 

“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,” the agency said in a statement.

The White House last month began requiring private insurance companies to cover the cost of eight at-home COVID-19 tests per person each month, if the customer files for reimbursement. The requirement was put in place as a result of the massive surge in infections due to the omicron variant.

But the policy did not apply to Medicare beneficiaries, and the exclusion of millions of older and disabled Americans triggered a backlash. Administration officials recognized the problem and have been working to find the best way forward. 

The problem was that traditional Medicare only pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests. If the test is ordered by a physician, pharmacist or “authorized health care professional,” there’s no cost to the beneficiary. 

Some people enrolled in Medicare Advantage, where beneficiaries join private managed care plans, might have been eligible for reimbursement, but each company sets its own rules so coverage varies.