HRSA CMS NEWS: Update
More than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have free access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests, according to the Biden-Harris Administration. For the period of COVID-19 public health emergency, people with Medicare can access up to eight tests per calendar month from participating pharmacies and healthcare providers.
According to Government Officials, they are increasing access to free over-the-counter COVID-19 testing for everyone with Medicare Part B, including those participating in a Medicare Advantage plan, with today’s announcement. Medicare Part B people will now have free access to up to eight FDA-approved, authorized, or cleared over-the-counter COVID-19 tests each month. This is all part of HHS Secretary Xavier Becerra’s overall aim to increase access to free, easy-to-use at-home tests. Biden illustrated, “Since taking office, we have more than tripled the number of locations where people can get free COVID-19 tests, and we’re also sending out almost 250 million at-home, fast tests to Americans who need them.” It will enforce state Medicaid programs, insurers, and group health plans to provide free testing for millions of Americans under the Biden-Harris Administration’s leadership.
This is the first time Medicare has provided free coverage for an over-the-counter self-administered test. In addition to the two sets of four free at-home COVID-19 tests, Americans may order through covidtests.gov. This new program allows Medicare to pay directly to participating eligible pharmacies and other healthcare providers, allowing Medicare beneficiaries to receive tests at no cost. National pharmacy chains are participating in this initiative, including Costco Pharmacy, Albertsons Companies, Inc., CVS, Giant Food, Food Lion, The Giant Company, H-E-B Pharmacy, Hannaford Pharmacies, Kroger Family of Pharmacies, Hy-Vee Pharmacy, Rite Aid Corp., Shop & Stop, Walmart and Walgreens.
Testing is still an important tool in preventing the spread of COVID-19, and CMS Administrator Chiquita Brooks-LaSure quoted, “We are dedicated to ensuring that people with Medicare have the tools they need to stay safe and healthy”.
Certain pharmacies and other healthcare providers who are enrolled in Medicare and able to provide ambulatory healthcare services including preventative vaccines, COVID-19 testing, and regular medical visits are eligible to participate. Medicare will not require participating eligible pharmacies and healthcare providers to go through any new Medicare enrollment processes to ensure that people with Medicare have access to these tests. This initiative is open to healthcare providers who currently provide ambulatory healthcare services to Medicare beneficiaries, such as vaccines, lab tests, or other clinic visits.
“Medicare is paying for an over-the-counter test for the first time in its history,” said CMS Deputy Administrator Dr. Meena Seshamani, director of the Center for Medicare. “This is because COVID-19 testing is an essential component of our pandemic response.” This initiative, when combined with the free over-the-counter tests available through covidtests.gov, will significantly increase testing access for Americans most vulnerable to COVID-19 and provide valuable data for future payment policy that supports accessible, comprehensive person-centered healthcare.
This link will take you to a list of eligible pharmacies and other healthcare providers that have publicly committed to taking part in this initiative. People with Medicare should check with their pharmacist or healthcare provider to see whether they are participating because there may be additional qualifying pharmacies and healthcare providers.
This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:
- Use the government’s website to request free over-the-counter testing be sent to your home. Every household in the United States can order two sets of four COVID-19 tests to be completed at home.
- Over 20,000 testing sites across the country provide no-cost COVID-19 tests via health care professionals. You may find a list of community-based testing sites here.
- Medicare covers the cost of lab-based PCR testing and antigen tests ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care provider.
- During a public health emergency, people with Medicare can have one lab-performed test without order or cost-sharing, in addition to a COVID-19 laboratory test requested by a health care provider.