People with Medicare will soon be able to get the cost of at-home COVID-19 testing kits covered. But the benefit will come weeks or perhaps even months after it's been available to millions of privately insured Americans.
The Centers for Medicare and Medicaid Services (CMS) just announced a forthcoming program to provide Medicare beneficiaries with up to eight free at-home COVID-19 tests per month from participating pharmacies.
“Medicare does not currently pay for over-the-counter COVID-19 tests,” the CMS says, but notes Medicare will begin covering the tests “in early spring 2022.”
Meanwhile, most Americans already have access to free tests. As of Jan. 15, people with private health insurance have been eligible for coverage of up to eight at-home tests per month, per person included on the health plan, as part of a White House testing program to combat the rampant spread of Omicron. Only at-home tests cleared by the Food and Drug Administration are covered.
Medicare beneficiaries were left out of the initial program, in effect excluding more than 63 million Americans who skew older and are at higher risk of death and severe illness from COVID-19.
“This is a perfect example of how dysfunctional Medicare and our health system in general has been,” says Mary Johnson, a Medicare and Social Security policy analyst at The Senior Citizens League.
In lieu of free at-home tests, government officials have been urging Medicare beneficiaries to utilize the current testing options, which include thousands of free in-person testing sites and free lab testing when ordered and administered from their physicians.
As Johnson notes, for older or disabled people who have Medicare instead of private insurance, those options can be logistical nightmares — and downright dangerous. They're likely to result in at-risk folks congregating in crowded lines and waiting rooms with other people who are potentially sick with COVID-19.
“It doesn’t make sense,” she says. To get testing through the currently available options, “there are usually a lot of hoops to jump through, and it’s not convenient.”
In the meantime, all Americans — regardless of insurance status — are eligible for home delivery of four free at-home COVID-19 tests. Tests are available online at COVIDtests.gov or by phone at 1-800-232-0233 and are shipped by the U.S. Postal Service.
For weeks, advocacy groups, lawmakers and Medicare beneficiaries themselves have been urging the Biden administration and other federal agencies to get Medicare to cover at-home test costs.
“We know that people 65 and older are at much greater risk of serious illness and death from this disease – they need equal access to tools that can help keep them safe,” said Nancy LeaMond, an executive vice president at AARP, in a Feb. 3 news release.
The CMS appears to have changed course due to the outcry, but Medicare beneficiaries will still have to wait at least another month to get their at-home tests covered. Folks with Medicare Advantage Plans may already qualify for free at-home COVID-19 tests because those plans are administered by private insurance companies. The CMS recommends checking directly with the provider to confirm.
How and when can Medicare beneficiaries get free COVID-19 tests?
While The Senior Citizens League's Johnson welcomes the Medicare policy change as good news, she is concerned with exactly how and when the program will roll out — and which pharmacies will offer the tests.
In the CMS's response to Money's inquiries, it would not provide a time frame beyond "early spring." As for which pharmacies are participating, the CMS says those details are still "under development" but will be available soon.
Johnson also expressed concern that at-home tests may not be the best choice for everyone on Medicare. Many older and/or disabled folks may have trouble performing the tests correctly, which could lead to inaccurate results unless administered by a caregiver or medical professional.
Still, Johnson says it’s a net win.
“Not going into the doctor’s office,” she says, “that’s going to make a whole lot of people relieved that they don’t have to make that trip.”