NEWS

Medicare Doesn't Cover At-Home COVID Tests. Where Can You Get One for Free?

covid-19 at home test mail order

Verywell Health / Laura Porter

Key Takeaways

  • Medicare beneficiaries cannot be reimbursed for at-home COVID-19 tests because the program is barred from covering self-administered diagnostic tests.
  • Medicare only cover the costs of COVID tests ordered by healthcare professionals.
  • People covered by Medicare can order free at-home COVID tests provided by the government or visit a pharmacy testing site.

Private health insurers are now required to cover or reimburse the costs of up to eight COVID-19 at-home tests per person per month. While Medicaid programs can also cover at-home tests on a state-by-state basis, Medicare does not.

Medicare is a federal program that provides healthcare payment coverage for people 65 and older, and younger people with permanent kidney failure. This demographic is also at high risk of severe illness from COVID-19, but the coverage gap in Medicare prohibits reimbursements for over-the-counter diagnostic tests. Offering coverage for at-home COVID-19 tests will require Medicare’s rules be rewritten.

But Medicare is aware of the problem. The Centers for Medicare and Medicaid Services (CMS) is looking for ways that beneficiaries can obtain rapid at-home antigen tests COVID-19, according to a CMS spokesperson.

“While at this time, original Medicare does not pay for over-the-counter, at-home COVID-19 tests, CMS is exploring ways that Medicare can cover them as we look to overcome a number of statutory and regulatory hurdles,” the spokesperson told Verywell in an email.

Adam E. Block, PhD, an assistant professor of public health at New York Medical College, said that overcoming the coverage gap would not be that complicated for health authorities if they had a desire to fix the issue.

Telehealth visits, for example, were not covered by Medicare before March 2020, but the rules were changed as a result of the pandemic, Block said.

Medicare Advantage Plans May Cover COVID-19 Tests

Medicare will pay for COVID-19 PCR or rapid tests when they are ordered by a healthcare professional and performed by a laboratory. Currently, a Medicare beneficiary can get one free test performed by a laboratory per year without an order.

However, Medicare Advantage plans offered by private insurers with a federal contract may cover at-home tests, according to David Allen, director of communications and public affairs for AHIP, a trade group for the health insurance industry.

“Every American should have access to the COVID-19 tests they need, and from the beginning, health insurance providers have covered the full cost of medically necessary COVID-19 tests,” Allen told Verywell in an email.

“For many seniors with Medicare Advantage, health insurance providers have sent a clinician to their home to administer a test, to protect them from additional risk of infection,” he added.

How to Get Free At-Home Test Kits

If you’re showing symptoms of COVID-19 or you’ve come in contact with someone who has COVID-19, you should get tested three to five days after the exposure.

If you have Medicare, there are other ways to get test kits at no cost. You can request free at-home tests at covidtests.gov.

The Department of Health and Human Services (HHS) is working to provide 50 million free at-home tests to community health centers and Medicare-certified clinics as well. The government has also set up over 10,000 pharmacy testing sites that provide testing for free regardless of your insurance coverage. You can find a testing location near you on the HHS website here.

What This Means For You

Medicare beneficiaries, unlike people with private insurance or Medicaid, cannot be reimbursed for at-home COVID-19 tests because the program is barred from covering self-administered diagnostic tests. But there are other ways to get free at-home COVID tests in the meantime, such as ordering from covidtests.gov or finding a pharmacy testing site here.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

Was this page helpful?
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Department of Health & Human Services. Who is eligible for Medicare?

  2. Centers for Medicare and Medicaid Services. How to get your at-home over-the-counter COVID-19 test for free.