Medicare to start paying for COVID-19 tests by spring

Beneficiaries can get up to 8 coronavirus tests per month

The Centers for Medicare & Medicaid Services (CMS) announced Thursday that Medicare would cover free over-the-counter (OTC) COVID-19 tests beginning early this spring.

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Original Medicare and Medicare Advantage beneficiaries will be able to access as many as eight OTC COVID-19 tests per month for free through eligible pharmacies and other participants. 

The initiative will enable payment from Medicare directly to pharmacies and other entities.

The policy will apply to tests approved or authorized by the 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," the CMS said in a news release. 

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Until the spring, people who had Medicare can still access free COVID-19 tests by requesting four free OTC tests for home delivery at the federal website covidtests.gov, going to health care providers at more than 20,000 free testing sites nationwide and accessing lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, nonphysician practitioner, pharmacist or other authorized health care professional at no cost.

People with Medicare also already have access to one lab-performed test without an order and without cost-sharing during the coronavirus pandemic.

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Lastly, CMS noted that Medicare Advantage plans may offer coverage and payment for OTC COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits and instruct beneficiaries covered by Medicare Advantage to check their plan. 

All Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.