Medicare covers COVID-19 tests at no cost to you

Medicare Part B covers COVID-19 diagnostic tests, antibody tests, and at-home test kits without charging you a copay, coinsurance, or deductible. This means you pay nothing out of pocket when you get tested through a provider that accepts Medicare. The coverage applies whether you have symptoms or are getting tested for screening purposes.

The test must be ordered by a doctor, nurse practitioner, physician assistant, or other may have access to healthcare provider. You cannot straightforward walk into a pharmacy and have Medicare cover a test you order yourself — a provider has to order it first. Once ordered, you can get tested at a hospital, clinic, urgent care center, doctor's office, pharmacy, or through a home test kit that your provider recommends.

This coverage is permanent, not temporary. It remains in place as long as the test is medically reasonable and necessary, which means your provider believes you need it based on your symptoms, exposure, or medical situation.

Key Takeaways

  • Medicare Part B pays the full cost of COVID-19 tests when a healthcare provider orders them, with no copay or deductible.
  • You must have a provider order the test — you cannot buy an over-the-counter test and submit it to Medicare for payment.
  • Tests ordered through pharmacies, clinics, urgent care centers, and doctors' offices are all covered as long as a provider placed the order.
  • At-home test kits are covered when your provider orders them, but you need to follow your provider's instructions on how to use and report the result.
  • If you have Medicare Advantage (Part C), your plan must cover COVID-19 tests at the same zero cost as Original Medicare.

How to get a COVID-19 test through Medicare

Call your doctor's office and tell them you need a COVID-19 test. They will place the order and tell you where to go or what to do next. Some offices have testing available on-site; others will direct you to a nearby location. If you do not have a regular doctor, you can visit an urgent care center or walk-in clinic and ask for a COVID-19 test — the provider there can order it for you.

When you arrive for the test, bring your Medicare card. Tell the staff that Medicare is paying for it. They will verify your coverage and process the test at no cost to you. If the location tries to charge you a copay or asks you to pay upfront, tell them Medicare covers COVID-19 tests with no cost sharing and ask to speak with their billing department.

For at-home test kits, ask your doctor if they can order one for you. Some doctors can send a kit directly to your home or direct you to a pharmacy where you can pick one up. Follow the instructions that come with the kit and report your result to your provider as directed.

What types of COVID-19 tests are covered

Medicare covers three main types of COVID-19 tests: diagnostic tests (which tell you if you currently have COVID-19), antibody tests (which show if you had COVID-19 in the past), and at-home test kits (which you use yourself at home). All three are covered at no cost when ordered by a provider.

Diagnostic tests include nasal swabs, throat swabs, saliva tests, and blood tests. These are the tests used to learn about you have COVID-19 right now. Antibody tests check your blood to see if you have developed immunity from a past infection. At-home kits are rapid antigen tests that you perform yourself and read the result within 15 to 30 minutes.

The specific test your provider orders depends on your situation. If you have symptoms or were exposed to COVID-19, your provider will likely order a diagnostic test. If you want to know whether you had COVID-19 in the past, your provider may order an antibody test. Your provider decides which test makes sense for your medical situation.

Medicare Advantage plans and COVID-19 tests

If you have Medicare Advantage (Part C), your plan must cover COVID-19 tests at no cost to you, just like Original Medicare does. This is a federal requirement — all Medicare Advantage plans are required to provide the same zero-cost coverage for COVID-19 testing.

However, your plan may have a network of preferred providers. If you go to an out-of-network provider for a COVID-19 test, you might be charged more. To avoid any surprise costs, call your Medicare Advantage plan before you get tested and ask which locations near you are in-network. Your plan's customer service number is on the back of your insurance card.

Some Medicare Advantage plans also cover additional preventive services beyond what Original Medicare covers. If you want to know the full details of your plan's COVID-19 testing coverage, call your plan directly or check your plan's coverage documents.

What happens if you are charged for a COVID-19 test

If a provider charges you for a COVID-19 test that Medicare should have covered, you have the right to dispute the charge. First, ask the provider's billing department why they charged you. Explain that Medicare covers COVID-19 tests at no cost and ask them to reprocess the claim or remove the charge.

If the provider refuses to remove the charge, contact Medicare directly. You can call 1-800-MEDICARE (1-800-633-4227) and explain what happened. Medicare can investigate whether the provider was supposed to cover the test at no cost and may be able to help you get a refund.

Keep your test receipt and any bills you receive. Write down the date of the test, the provider's name, and the amount you were charged. This information will help Medicare look into the issue.

When your provider might not order a COVID-19 test

Your provider may decide that a COVID-19 test is not medically necessary in your situation. For example, if you have no symptoms and no known exposure to COVID-19, your provider might decline to order a test. Medicare only covers tests that a provider believes are reasonable and necessary based on your health.

If your provider will not order a test but you believe you need one, you can ask why and discuss your concerns. You can also get a second opinion from another doctor. However, Medicare will only pay for tests that a licensed provider has ordered.

If you want to buy a COVID-19 test on your own without a provider's order, you can do so, but Medicare will not pay for it. You would pay the full cost yourself.

Frequently Asked Questions

Can I buy an over-the-counter COVID-19 test and have Medicare pay for it?

No. Medicare only covers tests that a healthcare provider orders. If you buy a test on your own at a pharmacy or online, Medicare will not reimburse you. You must have a doctor, nurse practitioner, or other may have access to provider place the order first.

Do I need a copay or deductible for a COVID-19 test?

No. Medicare Part B covers COVID-19 tests with zero cost sharing — no copay, coinsurance, or deductible applies. You should never be charged anything for a test that a provider has ordered.

What if I have both Medicare and another insurance plan?

Tell the provider that you have Medicare and let them know about your other insurance. Medicare will be the primary payer for COVID-19 tests. Your other insurance may cover additional costs, but Medicare's zero-cost coverage means you should not owe anything.

Can I get a COVID-19 test at a pharmacy without seeing a doctor first?

Some pharmacies have nurse practitioners or physician assistants on staff who can order tests. You can call a pharmacy and ask if they can order a COVID-19 test for you. If they can, they will place the order and perform the test on the same visit, and Medicare will cover it at no cost.

Are COVID-19 antibody tests covered the same way as diagnostic tests?

Yes. Medicare covers antibody tests at no cost when a provider orders them, just like diagnostic tests. Antibody tests show whether you have developed immunity from a past COVID-19 infection and are useful if you want to know your immune status.