Does Medicare Cover COVID-19 Testing and Services?

*Oral antiviral treatments for COVID-19 are expected to be covered by Part D once they receive FDA approval and the current federal supply is depleted.

Original Medicare and Medicare Advantage cover a variety of treatments, vaccines and health care services for COVID-19. But your out-of-pocket costs for some services and treatments can vary depending on the length of your treatment and the type of Medicare coverage you have.

Under Original Medicare, Medicare Part A covers services related to inpatient hospital, hospice and skilled nursing facility care. Medicare Part B covers outpatient services, including doctor visits. Medicare Advantage plans are required to cover the same services as Original Medicare.

The public health emergency declaration for COVID-19 has provided additional coverage for COVID-19 related instances.

However, the Department of Health and Human Services will likely stop renewing the emergency declaration in 2023. The public health emergency for COVID-19 was last renewed on Oct. 13, 2022, for an additional 90 days.

Yes, Original Medicare and Medicare Advantage cover at-home COVID-19 tests. You can get eight tests per covered individual each month. Depending on your insurer, the tests will either be free-of-charge or you’ll be reimbursed.

You can also purchase at-home COVID-19 tests from pharmacies or retailers and be reimbursed, or they could be free.

The Biden-Harris Administration is incentivizing health plans and insurers to allow beneficiaries to pick up at-home over-the-counter COVID-19 tests for free, rather than going through the process of having to submit claims for reimbursement.

Each Medicare Advantage plan has different OTC supplemental coverage. “While there are some plans that are increasing their OTC benefit next year (2023) to $100, even $150 a quarter, the average we see is about $45 a quarter to spend on OTC items,” Mike Jones, a Grand Anchor Insurance agent told RetireGuide.

For example, UnitedHealthcare plans cover up to $40 of OTC products per quarter. COVID-19 tests are typically around $12. This means three COVID-19 tests would be covered every three months under certain UnitedHealthcare plans.

Each plan varies, so check your OTC supplement benefits before ordering your OTC COVID-19 tests.

Medicare covers the costs of lab tests to see if you currently have COVID-19 as well as FDA-authorized antibody, or serology, tests that can determine if you had COVID-19 in the past. If you have Medicare, you will have no out-of-pocket costs for these tests.

Remember that your coverage for COVID-19 tests and treatment will likely change once the public health emergency ends. The Kaiser Family Foundation hosted a panel of experts to discuss the future of Medicare’s coverage for COVID-19 on Oct. 19, 2022.

Jen Kates, the Executive Vice President for Health Policy with the Kaiser Family Foundation offered insight on future coverage. “It’s a bit different for treatment and tests. Under the current federal emergency situation, most can get free supplies when they are purchased from the government. However, once the public emergency ends, a lot of people could face cost-sharing. In some cases, you could be denied coverage.”

Medicare’s coverage for COVID-19 will lessen in 2023 if funding isn’t provided. You’ll also have potential cost sharing, or could even be denied coverage once the public health emergency ends. Treatments and tests are most likely to face the biggest changes.

Dawn O’Connell, Assistant Secretary for Preparedness and Response of the U.S. Department of Health and Human Services, attended Kaiser’s panel of experts that discussed COVID-19 coverage. She is part of the team looking into the 2024 budget for funding. “We’re looking into the FY 2024 budget and adding The Enduring COVID Response to bridge gaps. If we don’t get additional supplemental funding, we’re exploring other options, like the Biomedical Advanced Research and Development Authority (BARDA).”

If you are on Medicare and require health care because of COVID-19, you may have to pay out-of-pocket expenses. These expenses include deductibles, copayments and coinsurance.

If you have a Medigap policy, it may offset some of these out-of-pocket costs.

Check with the plan administrator for your Medigap or Medicare Advantage plan to find out exactly what your responsibilities may be if you are treated for COVID-19.

Although the free mailed Covid-19 test program was suspended on Sept. 2, 2022 — it’s now available again as of Dec. 2022. You can order four rapid COVID-19 tests to your front door for free at COVID.gov. This next round of tests should start shipping during the week of Dec. 19.

There are over 15,000 free COVID-19 testing sites in the U.S. Even if you are uninsured, you can still get free testing.

The U.S. Department of Health & Human Services has an online resource tool if you need help finding a free COVID-19 testing location near you. If you need additional help finding a testing location, you can also call 1-800-633-4227 for more information.

You can also be reimbursed for eight at-home COVID-19 tests per month. In some cases, your insurer will allow you to skip the reimbursement process and the test will be free of cost at the time of purchase.

You’ll also face no costs if you get tested for COVID-19 from a laboratory, pharmacy, doctor or hospital — as long as the COVID-19 public health emergency is still in effect.