Medicare to Cover Free OTC COVID Tests by Spring 2022 - Investopedia

In a statement issued Feb. 3, the Centers for Medicare & Medicaid Services said it will provide free over-the-counter rapid COVID-19 tests through "eligible pharmacies and other participating entities" beginning in the “early spring.”

Medicare beneficiaries have several other channels through which they can obtain free COVID-19 tests while waiting for the early spring rollout of this program. (See below.)

The new policy will apply to over-the-counter COVID-19 tests approved by the Food and Drug Administration (FDA) and covers anyone enrolled in either Original Medicare (Parts A&B) or Medicare Advantage (Part C). Once the program is active you will be able to pick up as many as eight tests per month for free.

Key Takeaways

• Medicare recipients will have access to 8 rapid COVID-19 tests per month beginning in early spring.
• Tests will be available at eligible local pharmacies and other providers approved by the government.
• Until then, Medicare recipients have several other ways to obtain free over-the-counter (OTC) rapid tests, including through covidtests.gov.
• A number of issues have made it difficult for the government to pay for OTC COVID-19 tests.
• This is the first time Medicare has covered an OTC test at no cost to beneficiaries.

How to Obtain Free Tests Now

Until free tests are available at local pharmacies and medical providers, Medicare beneficiaries can access free tests through a number of different channels, including by:

• Requesting four free over-the-counter tests for home delivery at covidtests.gov.
• Accessing COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide.
• Accessing free lab-based COVID-19 PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost.
• Medicare beneficiaries can also access one free lab-performed test without an order during the public health emergency.
• Medicare Advantage plans may offer coverage and payment for over-the-counter 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 coverage are eligible for the new benefit, whether they are enrolled in a Medicare Advantage plan or not.

Why Not Sooner?

According to the CMS, this is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries. This move by the Biden administration is apparently designed to resolve one of the major complaints about Medicare coverage during the COVID-19 pandemic—the exclusion of Medicare recipients from the Jan. 10, 2022, announcement mandating access to free at-home COVID-19 tests from a local supplier.

Prior to the Feb. 3 announcement, Medicare laws did not allow coverage of self-administered diagnostic tests. This, of course, is what rapid COVID-19 tests are. CMS explained its reasoning in an FAQ issued Sept. 2, 2020 and updated Nov. 17, 2021: "We believe that broad COVID-19 testing without the order of any healthcare professional—including testing for the related conditions identified in the May 8th COVID-19 IFC—may result in a beneficiary not receiving the medical attention and oversight required to ensure that diagnosis and treatment is applied consistent with CDC guidelines and other medical standards."

Put simply, on Feb. 3, CMS found a way to allow coverage of self-administered diagnostics as well as overcome another hurdle, that of figuring out how to code these tests for billing so providers could be paid.

The Bottom Line for Medicare Recipients

If you are a Medicare recipient, you have several ways to access free COVID-19 testing. First, you can go through your medical provider and ask them to order a test for you. You can order four free rapid COVID-19 tests online through www.covidtests.gov. More than 20,000 community testing sites offer COVID tests to seniors free of charge. If you have Medicare Advantage your plan may already offer free access to at-home COVID tests—contact your plan provider to find out.

Finally, you can wait until rapid tests are available through local pharmacies and medical providers in early spring. Watch local news coverage or check at CMS.gov for information about the anticipated rollout of this new program.

Adblock test (Why?)

Medicare to Cover Free OTC COVID Tests by Spring 2022 - Investopedia
Read More