Medicare covers COVID-19 tests at no cost to you, with some limits on how many tests you can get

Medicare Part B pays for COVID-19 tests ordered by a doctor or other may have access to healthcare provider. You pay nothing out of pocket — no copay, coinsurance, or deductible — as long as you use an in-network provider and the test is medically necessary. The coverage applies to all three main types of COVID tests: molecular tests (the most accurate), antigen tests (faster results), and antibody tests (to check if you had COVID before).

The catch is quantity. Medicare limits you to one at-home test per month, and one in-person test per month. If your doctor orders more than that, you may have to pay for the extras yourself. Some people with ongoing health conditions or frequent exposure may need more tests, so it's worth asking your doctor whether they think you need additional testing — they can sometimes document medical necessity to override the monthly limit.

Key Takeaways

  • Medicare Part B covers COVID-19 tests with no copay or deductible when ordered by your doctor.
  • You are limited to one at-home test and one in-person test per month under standard Medicare coverage.
  • Tests must be ordered by a healthcare provider to be covered; over-the-counter tests you buy on your own are not covered.
  • If you have a Medicare Advantage plan, check your plan documents because coverage rules may differ from Original Medicare.

How to get a covered COVID test through Medicare

Call your doctor's office and tell them you need a COVID-19 test. They will order it for you. Your doctor can order an at-home test kit to be mailed to you, or they can schedule you for an in-person test at their office, a lab, or a testing site they work with. Either way, Medicare pays the provider directly.

When you pick up an at-home test kit or arrive for an in-person test, bring your Medicare card. The provider will verify your coverage before the test. If the test is done at a lab or testing site, ask them to bill Medicare before you leave — do not pay out of pocket and try to get reimbursed later, because that is slower and more complicated.

If your doctor orders the test through a pharmacy like CVS or Walgreens, the same rule applies: show your Medicare card, and the pharmacy will bill Medicare directly. You should not pay anything.

What happens if you buy a test without a doctor's order

If you buy a COVID-19 test on your own at a drugstore or online without a doctor's order, Medicare does not cover it. You pay the full cost yourself. This is true even if you later test positive and wish you had gotten a covered test instead.

The one exception is if you are in a hospital or skilled nursing facility. Those facilities can provide COVID tests as part of your care, and Medicare covers them as part of your inpatient stay — you do not need a separate doctor's order.

Medicare Advantage plans and COVID test coverage

If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your plan may cover COVID tests differently. Some Advantage plans cover more than one test per month, or they may have different rules about which providers you can use. A few plans cover over-the-counter tests you buy yourself, though this is less common.

Check your plan's coverage document or call the plan's customer service number on the back of your card. Tell them you want to know about COVID-19 test coverage, including how many tests per month and whether you need a doctor's order. Having this information before you need a test saves time and confusion.

If you need more than one test per month

If your doctor thinks you need more COVID tests than Medicare's monthly limit allows, ask them to document the medical reason in your chart. This might be because you have a weakened immune system, you work in healthcare or a congregate setting, or you have had recent exposure to someone with COVID. Your doctor can submit this documentation to Medicare along with the test order.

Medicare may override the monthly limit if the medical reason is clear. There is no may provide, but it is worth asking your doctor to try. If Medicare denies coverage for the extra test, you will receive a notice explaining why, and you can appeal it if you disagree.

Where to get tested if you do not have a regular doctor

If you do not have a primary care doctor, you can still get a covered COVID test. Call your local health department and ask where you can get a test ordered by a healthcare provider. Many health departments run testing sites and can order tests for you on the spot. Community health centers also offer COVID testing and can order tests for uninsured or underinsured people — Medicare will cover yours.

You can also call 211 (a free referral service) and ask for COVID testing sites near you. When you call or visit, tell them you have Medicare and ask whether the site can order a test for you so Medicare covers it. Most sites can, but it is better to confirm before you go.

What to do if a provider bills you for a COVID test

If a healthcare provider sends you a bill for a COVID-19 test that your doctor ordered, do not ignore it. Call the provider's billing department and tell them you have Medicare and the test should have been covered. Ask them to resubmit the claim to Medicare. Most billing mistakes are fixed this way.

If the provider insists you owe the money, ask for an itemized bill showing the test date, the type of test, and the provider's Medicare billing number. Then call Medicare at 1-800-MEDICARE (1-800-633-4227) and report the issue. Medicare can investigate whether the provider was paid and why you received a bill.

Frequently Asked Questions

Do I need a doctor's order to get a COVID test covered by Medicare?

Yes. Medicare only covers COVID tests that a doctor or may have access to healthcare provider orders. Over-the-counter tests you buy yourself are not covered, even if you later test positive. If you do not have a regular doctor, call your local health department or a community health center — they can order a test for you.

Can I get more than one COVID test per month if I work in healthcare?

You may be able to. Ask your doctor to document that your job requires frequent testing and submit that information with your test order. Medicare sometimes overrides the monthly limit for people with ongoing exposure risk, but approval is not may provide. Your doctor can explain what documentation Medicare needs.

Does Medicare Advantage cover COVID tests the same way as Original Medicare?

Not always. Some Advantage plans cover more tests per month, and a few cover over-the-counter tests. Check your plan's coverage document or call the customer service number on your card to find out your specific coverage before you need a test.

What if I already paid for a COVID test out of pocket?

If a doctor ordered the test and you paid because the provider did not bill Medicare, you may be able to get reimbursed. Ask the provider for an itemized receipt and a copy of the doctor's order, then call Medicare at 1-800-MEDICARE to ask about reimbursement. Keep all paperwork while your request is being reviewed.

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

Yes. Antibody tests (which check whether you had COVID in the past) are covered by Medicare under the same rules as diagnostic tests — one per month, ordered by a doctor, no copay. However, antibody tests are less commonly ordered than diagnostic tests, so ask your doctor whether an antibody test is the right choice for your situation.