Questioning Medicare's Limits on at Home COVID Tests - is it covered?
Did you know Medicare coverage varies from plan to plan? Even the coverage for at home tests is subject to different guidelines. Fortunately, most insurers will allow for certain preventive health care items to be covered. This article helps you determine if your insurance covers COVID-19 test kit and how much you’re required to pay yourself.
On January 15th, 2022, a new directive was passed that insurance companies are required to cover up to 8 over-the-counter COVID tests a month. Medicare beneficiaries are excluded from this under Original Medicare. But under the new directive, insurance companies can choose to allow clients to file for a reimbursement claim after they have already purchased the test.
According to Medicare.gov, Original Medicare does not currently cover at-home testing kits. So what does it cover when you need to get tested? Well, there is good news–original Medicare Part B still covers COVID tests from your pharmacy, doctor, or hospital. Another option is through community health centers or through the federal website.
However, there are some Medicare Advantage plans that may cover and pay for take-home COVID-19 tests, and State Medicaid is already required to cover home testing kits. Medicare.gov has stated that you will need to check with your provider to see if this benefit is added.
Ordering tests through community health centers and the federal website has already been met with backlash–as some Medicare beneficiaries do not have access to transportation and must rely on family or friends to take them to get a Covid test. Some do not have access to the internet to be able to order the tests online or need access to them sooner than the suggested 7-14 business day shipping time.
While this ruling will likely affect many older Americans who are most at-risk for COVID exposure, it is still no guarantee that Medicare Advantage plans and those on Original Medicare will cover this test. This means that you will likely have to pay out-of-pocket for the test if you want to get it covered as there are no current plans to revise the new directive to accommodate those on original Medicare.
Sources:
https://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-tests
https://www.aarp.org/health/conditions-treatments/info-2022/free-rapid-covid-test.html
