Medicare covers COVID-19 tests at no cost to you

Medicare Part B pays for COVID-19 tests ordered by your doctor or other healthcare provider. You pay nothing out of pocket — no copay, no coinsurance, no deductible. This coverage applies whether you have symptoms, are exposed to someone with COVID-19, or need a test before a medical procedure or travel.

The coverage includes three types of tests: molecular tests (PCR), antigen tests, and antibody tests. Your provider orders the test, and Medicare pays the lab or testing site directly. You do not need to file a claim yourself.

This benefit has been in place since the start of the pandemic and remains active. However, the rules around what counts as "ordered by a provider" have specific boundaries, and some tests fall outside Medicare coverage.

Key Takeaways

  • Medicare Part B covers COVID-19 tests ordered by your doctor or healthcare provider at no cost to you.
  • Tests must be ordered by a provider — over-the-counter home tests you buy yourself are not covered by Medicare.
  • Molecular tests (PCR), antigen tests, and antibody tests are all covered when ordered by a provider.
  • You can get tested at hospitals, urgent care clinics, doctor's offices, pharmacies, or other sites that bill Medicare directly.
  • If you pay out of pocket for a test, you cannot file a claim to get reimbursed later.

Which COVID-19 tests Medicare covers

Medicare covers three categories of COVID-19 tests. A molecular test (also called PCR or RT-PCR) detects the virus's genetic material and is considered the most accurate. An antigen test detects proteins on the virus surface and gives results faster, usually within 15 minutes. An antibody test (also called a serology test) checks whether your body has made antibodies to COVID-19, which shows past infection.

All three are covered when ordered by your doctor, nurse practitioner, physician assistant, or other may have access to provider. The provider must order the test — you cannot straightforward walk into a pharmacy and ask for a free test without a provider's order and have Medicare pay for it.

Over-the-counter home tests that you buy yourself are not covered by Medicare, even if you later show the results to your doctor. Medicare only pays for tests that a provider orders and that a testing site bills to Medicare.

Where you can get a covered COVID-19 test

You can receive a covered test at many locations, as long as the site is enrolled with Medicare and bills Medicare directly. These include doctor's offices, urgent care clinics, hospital emergency departments, hospital outpatient labs, retail pharmacies (such as CVS, Walgreens, and Rite Aid), federally may have access to health centers, and some community testing sites.

Before you go, call ahead to confirm the site accepts Medicare and can order the test for you. Some pharmacies offer free tests to anyone, but if you want Medicare to pay, you need a provider's order. If you show up without an order, you may be asked to pay out of pocket or to contact your doctor first.

If you are homebound or in a nursing home, your doctor can order a test to be done at your location. Some home health agencies and mobile testing services bill Medicare directly for tests they perform.

How to get a test ordered

Contact your primary care doctor, nurse hotline, or urgent care clinic and tell them you need a COVID-19 test. Explain whether you have symptoms, were exposed to someone with COVID-19, or need the test for another reason (such as before surgery or travel). The provider will decide whether to order a test and which type.

You do not need to ask the provider to bill Medicare — that happens automatically when the testing site processes your Medicare card. Bring your Medicare card with you when you go for the test. If you do not have it with you, the testing site can look up your information using your name and Social Security number.

If your regular doctor is not available, you can call an urgent care clinic or visit a retail pharmacy that offers testing. Many pharmacies have nurse lines you can call to request a test order. Some telehealth providers also order COVID-19 tests, though you should confirm they can arrange testing in your area.

What happens if you pay out of pocket

If you pay for a COVID-19 test yourself — whether because you did not have a provider's order, went to a site that does not bill Medicare, or bought an over-the-counter test — Medicare will not reimburse you later. There is no process to submit a receipt and get your money back.

To avoid paying out of pocket, always get a provider's order before you go for a test, and confirm the testing site accepts Medicare. If a site tells you they cannot bill Medicare or that you must pay upfront, ask whether they can contact your doctor to place an order, or find a different testing location.

COVID-19 tests for Part A beneficiaries only

If you have Original Medicare Part A but not Part B, your coverage depends on where you are. Tests performed in a hospital (inpatient or outpatient) are covered under Part A. Tests at other locations, such as a doctor's office or pharmacy, are not covered unless you also have Part B.

If you are in a skilled nursing facility or home health setting, Part A covers the test as part of your care. If you are unsure whether you have Part B, check your Medicare card or call Medicare at 1-800-MEDICARE.

Medicare Advantage plans and COVID-19 tests

If you have a Medicare Advantage plan (Part C), your plan must cover COVID-19 tests at no cost to you, just as Original Medicare does. However, the specific testing sites and any prior authorization requirements may differ from Original Medicare.

Contact your Medicare Advantage plan to find out which testing sites are in-network and whether you need approval before getting a test. Some plans require you to use certain pharmacies or labs. If you go to an out-of-network site, you may be charged a copay or the full cost.

Frequently Asked Questions

Do I need a reason to get a COVID-19 test covered by Medicare?

No. Your provider can order a test whether you have symptoms, were exposed to someone with COVID-19, or want a test for any other reason. Medicare covers the test as long as a provider orders it.

Can I get a free at-home COVID-19 test through Medicare?

No. Medicare does not cover over-the-counter home tests. However, the federal government has distributed free home tests to households through other programs. Check covidtests.gov to see if you can order free tests by mail.

What if my doctor says I do not need a test but I want one anyway?

Your provider decides whether to order a test. If they decline, you can ask for a second opinion or contact an urgent care clinic. If you buy a test yourself, Medicare will not pay for it.

Will I be charged a copay or deductible for a COVID-19 test?

No. Medicare covers COVID-19 tests with no copay, coinsurance, or deductible. You should pay nothing at the testing site or afterward.

Can I get reimbursed if I already paid for a COVID-19 test?

No. Medicare does not reimburse for tests you paid for out of pocket. To avoid paying, always confirm the testing site accepts Medicare and that you have a provider's order before the test.