Can I get reimbursed for an at-home, over-the-counter COVID-19 test?
Update (October 13, 2022): The federal government extended the COVID-19 public health emergency for at least an additional 90 days. Over-the-counter COVID-19 tests for Medicare beneficiaries will continue to be covered by CMS.
Find more information on the CMS website.
Update (April 6, 2022): As of April 4, 2022, the Centers for Medicare and Medicaid Services (CMS) will cover over-the-counter COVID-19 tests for Medicare beneficiaries.
If you are eligible for Medicare and enrolled in the Health Options Program, you are eligible for up to eight free over-the-counter tests each month at participating pharmacies and health centers.
Claims for the tests will be processed and paid directly by CMS, not the Health Options Program or your Medicare Advantage Plan. The pharmacy or health center will bill Medicare on your behalf—make sure you show your red, white and blue Medicare card (not your health plan or pharmacy ID card) at checkout.
Note: You cannot be reimbursed for tests purchased prior to April 4.
Update (February 3, 2022): The Centers for Medicare and Medicaid Services (CMS) has announced Medicare will cover the cost of over-the-counter rapid COVID-19 tests beginning Spring 2022. Under this new policy, Health Options Program members can obtain up to eight free tests per month without need for reimbursement. This change will also apply to Medicare Advantage plans under the Health Options Program. We will provide another update when CMS announces a start date for the program. Until that time, over-the-counter tests are NOT covered.
The Health Options Program, which is a retiree-only plan, is not required to provide reimbursement for at-home, over-the-counter tests. Our members can, however, request free tests from the federal government through COVIDtests.gov. This new federal program offers every home in the U.S. four, free at-home tests. You may also find free tests at your local public library, fire station, or public testing site. In addition, tests prescribed by a physician and performed at a doctor’s office or hospital (FDA approved and not over-the-counter) are covered under the HOP Medical Plan, Value Plan and Pre-65 Medical Plan.
If you are enrolled in a Medicare Advantage plan, some may offer coverage and payment for at-home, over-the-counter COVID-19 tests. Check with your insurance carrier for details on whether you may receive reimbursement.
You can also find low or no-cost community-based testing sites on the Health & Human Services website.
Please see the U.S. Food and Drug Administration website or consult with your physician concerning when you should take a COVID-19 test.