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NEWS
ALERT
February
3, 2022
Contact:
CMS Media Relations
CMS Media Inquiries
Biden-Harris Administration Will
Cover Free Over-the-Counter COVID-19 Tests Through Medicare
CMS Developing Initiative
to Enable Access to Eight Free Over-the-Counter COVID-19 Tests for
Medicare Beneficiaries in Early Spring
As
part of the Biden-Harris Administration’s ongoing efforts to expand
Americans’ access to free testing, people in either Original Medicare
or Medicare Advantage will be able to get over-the-counter COVID-19
tests at no cost starting in early spring. Under the new initiative,
Medicare beneficiaries will be able to access up to eight
over-the-counter 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 over-the-counter tests approved or
authorized by the U.S. Food and Drug Administration (FDA).
This
is the first time that Medicare has covered an over-the-counter test at
no cost to beneficiaries. There are a number of issues that have made
it difficult to cover and pay for over-the-counter COVID-19 tests.
However, given the importance of expanding access to testing, CMS has
identified a pathway that will expand access to free over-the-counter
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 health
care professional at no cost. In addition to accessing a COVID-19
lab test ordered by a health care 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 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 are
eligible for the new benefit, whether enrolled in a Medicare
Advantage plan or not.
For
more information, please see these Frequently Asked Questions, https://www.cms.gov/files/document/covid-19-over-counter-otc-tests-medicare-frequently-asked-questions.pdf
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