- While Medicare was not included in the Biden administration's mandate that insurers cover the cost of at-home tests, there are ways to get them for free.
- That includes ordering them through a new government website or picking them up at a local Medicare-certified health clinic.
- Alternatively, lab tests are free when ordered by a doctor or other authorized health-care provider.
You may have discovered that Medicare doesn't cover the cost of at-home Covid tests.
While there are ways for beneficiaries to get free tests, a Biden administration mandate that private insurers cover the cost of at-home tests — up to eight per enrollee per month — does not extend to Medicare, including Advantage Plans.
"That's a major sticking point right now," said Juliette Cubanski, deputy director of the program on Medicare policy at the Kaiser Family Foundation. "It's a sore spot for Medicare beneficiaries, who are among the highest at risk when it comes to Covid."
About 63.3 million people are enrolled in Medicare. Most of the beneficiaries, 55.1 million, are age 65 or older, and the rest are generally younger with permanent disabilities.
The Biden administration's mandate, which took effect Jan. 15, means most consumers with private health coverage can buy an at-home test at a store or online and either get it paid for upfront by their insurer or get reimbursed by submitting a claim to their plan.
While Medicare was not included in the directive due to the specific legal authority used to implement it, there are ways for beneficiaries to get the at-home tests for free.
For starters, you can order four for free through Covidtests.gov, a new government website that officially launched Wednesday. The site, which is available to all households, requires you to provide only your name and address; no insurance information is needed.
"That's an option that all Medicare beneficiaries can tap to get access to free at-home testing," Cubanski said.
Additionally, there are Medicare-certified health clinics, as well as community health centers, where the at-home tests can be picked up for free. However, given that demand for the tests is generally outpacing supply, those facilities may also be struggling to maintain inventory, Cubanski said.
For beneficiaries who are enrolled in a Medicare Advantage Plan, it's worth checking whether the plan is covering at-home tests.
"It could be covered as a supplemental benefit but not a requirement," Cubanski said.
And, of course, beneficiaries can still access free testing outside their home.
"While at this time original Medicare cannot pay for at-home tests, testing remains a critical tool to help mitigate the spread of Covid," a CMS spokesperson said, adding that there are more than 20,000 free testing sites where beneficiaries can get lab-based PCR tests, rapid PCR tests and rapid antigen tests.
Also, if a doctor or other authorized health-care provider orders it, there is no cost-sharing for the test. Otherwise, beneficiaries are allowed to get one lab test for free per year without a doctor's order.
As for whether Medicare could eventually pay for at-home Covid tests, it would likely take congressional action to allow it, Cubanski said.
"But I have not heard any public discussion about making that happen," she said.