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Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free OTC COVID-19 Tests

Industry news | 08 April, 2022 | CACLP

The Biden-Harris Administration announced on April 4 that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared OTC COVID-19 tests at no cost. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.


“We are expanding access to free OTC COVID-19 testing for people with Medicare Part B, including those enrolled in a Medicare Advantage plan. People with Medicare Part B will now have access to up to eight FDA-approved, authorized or cleared OTC COVID-19 tests per month at no cost. This is all part of our overall strategy to ramp -up access to easy-to-use, at-home tests free of charge,” said HHS Secretary Xavier Becerra. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also delivering close to 250 million at-home, rapid tests to send for free to Americans who need them. Under the Biden-Harris Administration’s leadership, we required state Medicaid programs, insurers and group health plans to make tests free for millions of Americans. With today’s step, we are further expanding health insurance coverage of free OTC tests to Medicare beneficiaries, including our nation’s elderly and people with disabilities.”


This is the first time that Medicare has covered an OTC self-administered test at no cost to beneficiaries. This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the two sets of four free at-home COVID-19 tests Americans can continue to order from covidtests.gov. National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens and Walmart.


“Testing remains a critical tool in mitigating the spread of COVID-19, and we are committed to making sure people with Medicare have the tools they need to stay safe and healthy,” said Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. “By launching this initiative, the Biden-Harris Administration continues to demonstrate that we are doing everything possible to make OTC COVID-19 testing free and accessible for millions more Americans.”


Providers and suppliers eligible to participate include certain types of pharmacies and other health care providers who are enrolled in Medicare and able to furnish ambulatory health care services such as preventive vaccines, COVID-19 testing and regular medical visits. To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes. If a health care provider currently provides ambulatory health care services such as vaccines, lab tests or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.


“For the first time in its history, Medicare is paying for an OTC test,” said Deputy Administrator Dr. Meena Seshamani, Director of the Center for Medicare at CMS. “This is because COVID-19 testing is a critical part of our pandemic response. Combined with the free OTC tests available through covidtests.gov, this initiative will significantly increase testing access for Americans most vulnerable to COVID-19 and will provide valuable information for future payment policy supporting accessible, comprehensive, person-centered health care.”


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