Medicare's Current COVID Test Coverage
Medicare covers COVID-19 tests, but what it pays for depends on where you get tested and what type of test you use. If you get a test at a doctor's office, hospital, or approved lab, Medicare Part B covers it with no cost to you. If you buy an at-home test yourself at a pharmacy or online, Medicare does not reimburse you for it.
The rules have changed several times since 2020. Right now, Medicare covers lab-based tests (the kind a healthcare provider orders) at no charge. Over-the-counter tests you buy yourself are not covered, even if you have a prescription from your doctor.
Key Takeaways
- Medicare Part B covers COVID tests ordered by a doctor and performed at a medical facility, with no copay or deductible.
- At-home tests you purchase yourself are not covered by Medicare, regardless of whether your doctor recommends them.
- If you need a test, ask your doctor's office or local health department where to go for a covered test.
- Coverage rules have changed over time, so confirm what your specific plan covers before you pay out of pocket.
Tests Medicare Part B Covers
Medicare Part B covers nucleic acid amplification tests (NAATs), which are the most common type. These include nasopharyngeal swabs, oropharyngeal swabs, and saliva tests performed in a lab. Medicare also covers antigen tests when ordered by a healthcare provider and performed at a medical facility.
The test must be ordered by a doctor, nurse practitioner, or physician assistant. You cannot straightforward walk into a lab and request a test on your own; there needs to be a medical reason documented in your record. If you have symptoms or have been exposed to COVID-19, your doctor can order a test and direct you to a covered location.
When you receive a covered test at a doctor's office, hospital outpatient department, or Medicare-approved lab, you pay nothing. There is no copay, no deductible, and no coinsurance.
Tests and Purchases Medicare Does Not Cover
At-home rapid tests that you buy yourself—the kind you find at pharmacies, grocery stores, or online—are not covered by Medicare. This includes brand names like iHealth, BinaxNOW, and others. Even if your doctor tells you to use one, Medicare will not reimburse you for the cost.
Some people mistakenly believe that if they have a prescription from their doctor, Medicare will pay. That is not how it works. The coverage applies only to tests performed by a healthcare provider at a medical facility.
If you have a Medicare Advantage plan (Part C), check your plan documents or call the plan directly, because some Advantage plans may cover at-home tests as an extra benefit. Original Medicare (Part A and Part B) does not.
Where to Get a Covered COVID Test
Your doctor's office can order a test and tell you where to go. Many primary care offices have lab services on-site or can send you to a nearby lab they work with. You can also call your local health department—most offer free testing to anyone who needs it, regardless of insurance.
If you use a hospital's urgent care or emergency department, they can test you there. Federally may have access to health centers (FQHCs) also offer COVID tests and often charge on a sliding scale based on income if you are uninsured, though you should mention you have Medicare.
Before you go, confirm that the location accepts Medicare. Most do, but it is worth a quick phone call to avoid surprises.
What to Bring and What to Expect
Bring your Medicare card. The provider will need your name, date of birth, and Medicare number to bill Medicare correctly. If you also have a secondary insurance plan, bring that card too.
Tell the provider why you think you need a test—whether you have symptoms, were exposed, or are getting tested before a procedure. This information goes into your medical record and justifies the test to Medicare. The actual test takes a few minutes, and results usually come back within 24 to 48 hours, depending on the lab.
If You Have a Medicare Advantage Plan
Medicare Advantage plans (Part C) must cover at least what Original Medicare covers, so you will have no cost for a lab-based test ordered by a doctor. However, some Advantage plans offer additional coverage—such as a certain number of at-home tests per month—as an extra benefit.
Call your Advantage plan's customer service number (on the back of your card) and ask what COVID test coverage you have. Ask specifically whether they cover at-home tests and, if so, how many per month or year. Write down the answer and the date you called.
Frequently Asked Questions
Can I get Medicare to pay for an at-home test if my doctor prescribes it?
No. Medicare covers tests only when they are ordered by a doctor and performed at a medical facility by a healthcare provider. A prescription for an at-home test does not change that rule. If your doctor wants you tested, ask them where you can go for a covered test instead.
Do I have to pay anything if I get a test at my doctor's office?
No. Medicare Part B covers the full cost of a COVID test ordered by your doctor and performed at a medical facility. You should not receive a bill. If you do, contact Medicare at 1-800-MEDICARE to report it.
What if I get tested at an urgent care or emergency room?
Medicare covers COVID tests in those settings too, with no cost to you. The facility will bill Medicare directly. Make sure you bring your Medicare card so they can process the claim correctly.
Are at-home tests ever covered by Medicare?
Original Medicare does not cover at-home tests. Some Medicare Advantage plans may offer this as an extra benefit, so call your plan to ask. If you need a test, your doctor can order one at a covered location instead.
How do I know if a test location accepts Medicare?
Call ahead and ask. Most doctors' offices, hospitals, and large labs accept Medicare, but it is worth confirming. Your doctor's office can also tell you which locations they work with and whether they accept Medicare.