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Confused about Medicare and Covid Tests?



There has been a lot of confusion and questions from our Clients about the new Federal rule regarding private insurance companies being required to cover at home covid tests.

Private insurance and Medicare are often treated differently and fall under different rules. Refer to this article from CMS, who governs Medicare, about how Covid tests are covered by private insurance companies and Medicare. https://www.cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free


Now since Medicare rules are already in place, Medicare typically pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician or other authorized health care professional and can sometimes be limited to just one test a year. At this time original Medicare cannot pay for at-home tests through this program. Medicare Advantage plans may offer coverage and payment for at-home over-the-counter COVID-19 tests, so consumers covered by Medicare Advantage should check with their plan.


The Federal Government has recently created a website where Medicare beneficiaries or anyone with a U.S. residential address can order up to 4 tests per household. You can also find information on other ways to get tested. See covidtests.gov for more information.

photo by: Julia Koblitz from Unsplash








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