Under a new initiative, Medicare beneficiaries will be able to access up to eight over the counter (OTC) COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 OTC tests approved or authorized by the U.S. Food and Drug Administration (FDA).
This is the first time that Medicare has covered an OTC test at no cost to beneficiaries. There are a number of issues that have made it difficult to cover and pay for OTC COVID-19 tests. However, given the importance of expanding access to testing, CMS has identified a pathway that will expand access to free OTC testing for Medicare beneficiaries.
This new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. CMS anticipates that this option will be available to people with Medicare in the early spring.
Until then, people with Medicare can access free tests through a number of channels established by the Biden-Harris Administration. Medicare beneficiaries can:
- Request four free over-the-counter tests for home delivery at covidtests.gov.
- Access COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. A list of community-based testing sites can be found here.
- Access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized healthcare professional at no cost. In addition to accessing a COVID-19 lab test ordered by a healthcare professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency.
In addition:
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, so Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit.
All Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.
