Medicare does not yet cover at home testing kits but officials trying to change the law

WASHINGTON -- Can your Medicare patients get reimbursed for buying at-home rapid COVID tests? Sorry, no -- but we're working on changing that, say Medicare officials.

Although the Biden administration mandated that private insurers must reimburse patients for purchasing up to eight at-home tests per month, they did not mandate the same thing for traditional Medicare. However, "CMS [the Centers for Medicare & Medicaid Services] is exploring ways to expand testing options for Medicare beneficiaries," an agency spokesperson said in an email.

The spokesperson noted that Medicare beneficiaries can get four free rapid tests sent to their homes by going to the covidtests.gov website. They also can get free PCR tests at a lab when the test is ordered by a physician, non-physician practitioner, or pharmacist, and they can get a free rapid test at any of 20,000 community testing sites nationwide. Some Medicare Advantage plans may also cover at-home COVID tests, so Medicare Advantage enrollees should check with their plan, the spokesperson said.

The reason that traditional Medicare doesn't cover the tests is because current law doesn't provide for it, explained Casey Schwarz, JD, senior counsel for education and federal policy at the Medicare Rights Center, a consumer service and advocacy organization for Medicare beneficiaries. "We want CMS to expand the coverage if they can -- if they don't think they can, then Congress needs to act, but we think that that probably is something that CMS can do," she said in a phone interview. ...