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Medicare Now Covers At-Home COVID-19 Tests

In January 2022, the Federal Government mandated that private insurers reimburse members or pay pharmacies directly for up to eight over-the-counter, at-home COVID-19 tests per member, per month, without a prescription. To the disappointment of the millions on Medicare, the Medicare program was not required to comply with this mandate.

However, the government reversed course and as of April 4, 2022, Medicare will also pay for up to eight tests per month, per beneficiary who is enrolled in Medicare Part B.

Medicare beneficiaries can pick up the tests at a participating local pharmacy. Most major chains are participating in this program, as are many regional chains and pharmacies operating within grocery stores. Medicare provides a list here, although it is not exhaustive. If you don’t see the pharmacy you would like to use on the list, please contact that pharmacy directly. One cannot submit a claim for reimbursement of at-home COVID-19 tests to Medicare if purchased at a non-participating pharmacy, so make sure you use a participating pharmacy if you would like to take advantage of this benefit.

Usually, a Medicare Prescription Drug Plan card or Advantage Plan card is used at the pharmacy, but in this case one’s original Medicare card needs to be presented. This is highly unusual for those in Advantage Plans, since enrolling in an Advantage Plan usually makes one’s Medicare card effectively unusable. Nevertheless, original Medicare will pay the claims for at-home COVID-19 tests even for those enrolled in an Advantage Plan. So, if this applies to you, please locate your original Medicare ID card before going to the pharmacy.

This program is set to last until the official end of the COVID-19 public health emergency.

Please forward this information to anyone you feel would benefit from it.