Does Medicare Cover COVID Testing?

The COVID-19 pandemic has upended life around the world, with millions of cases worldwide and over a million deaths. While we’re learning how to function in a socially distanced world (seriously, wear your masks), preventing yourself from getting sick is only half the battle. If you do become one of the millions that catches COVID-19, you may not even know, since you could have an asymptomatic case. Symptoms may be extremely mild, displaying as a slight fever and a cough. Despite this, you could still be contagious and spread the disease without knowing.

Thankfully, there are tests available to help you know whether you have COVID or not. Unfortunately, these tests can be also limited due to supply shortages, to the point where the CDC suggests that not everyone needs a COVID test. If you are displaying symptoms or have been in contact with someone who contracted coronavirus, will Medicare cover your test?

Medicare & The COVID-19 Test

We’ll cut right to the chase. Yes, Original Medicare generally covers COVID testing. So long as you’re receiving the test in an approved location, people enrolled in Original Medicare should have no out-of-pocket costs to receive the test. If the test is given in the state you live in, Original Medicare should cover the coronavirus diagnostic test, as well as some tests that are related to other respiratory conditions that may help diagnose you with COVID by ruling out other similar conditions. In some circumstances, a test sample may be collected at home if done so by a Medicare-approved health care professional like a home health nurse or lab technician. The Centers for Medicare & Medicaid Services (CMS) have also expanded their coverage to include some unique testing locations, such as parking lot test sites that have been utilized in the face of the massive demand for tests.

Original Medicare should cover the coronavirus diagnostic test, as well as some tests that are related to other respiratory conditions.

If you have a Medicare Advantage plan, you may be wondering if you’ll have any costs to get a COVID test. Earlier in the pandemic, CMS reacted pretty quickly to expand coverage for beneficiaries of private Medicare plans like Advantage and Part D. Not only did this waive cost-sharing for COVID tests and treatments, it also gave more flexibility for coverage of services like telehealth appointments, mail delivery drugs, and prior authorizations. Now, no matter what type of Medicare coverage you receive, your COVID test is likely covered.

The COVID-19 Antibody Test & the Vaccine

The COVID-19 antibody test checks your immune system for signs that you have developed an immune response to the coronavirus. This would likely be the result of having had COVID-19 and recovered and imply that you may be somewhat immune to COVID-19 for the time being. That said, you should still socially distance and wear a mask. Currently, we’re not sure how effective these antibodies are for protecting us from a new infection or how long they’re effective for. There’s also the chance for a false positive, where the results come back positive as an error. The antibody test can be useful to determine who has had the illness, especially for tracing a pathway of infection purposes. For that reason, Medicare covers the coronavirus antibody test so that you don’t owe any out-of-pocket costs. This is true of both Original Medicare and Medicare Advantage, due to the expansion of coverage we discussed earlier.

CMS has said that it will cover the costs of vaccination when one becomes available.

There has also been a lot of talk about a vaccine for COVID-19, bringing hope to many that the release of a vaccine (or a number of effective and safe vaccines) could return life to normal. Unfortunately, even with the release of a vaccine, things won’t return to normal immediately, with estimates ranging between May and winter of 2021 (though some warn it could be even longer). That said, thorough vaccination of the population is an essential step to a safe return to normalcy for the United States, and Medicare has already sworn to do its part. CMS has said that it will cover the costs of vaccination when one becomes available.

How to Get a Test

If you’re thinking about getting a test for COVID-19, please remember that supplies are currently limited and there’s a backlog of tests in need of an analysis. This isn’t to discourage anyone from getting the test that is showing symptoms, only to remind readers that not everyone needs the test and that doing so can create issues for an already-taxed health care system. If you’re not showing any symptoms and haven’t come into close contact with someone who has tested positive, you likely don’t need a test. If you are showing symptoms, you have two choices. You can assume you have coronavirus and self-isolate until it’s safe to be around others. Or, you can get the test to know for sure. If you’ve been around someone who has tested positive, you should get the test, even if you don’t currently have symptoms.

f you are showing symptoms, you have two choices: assume you have it and self-isolate or get the test to know for sure.

To start the process of getting a COVID-19 test, the Centers for Disease Control and Prevention (CDC) suggests starting by checking your state and local health departments for in-depth information on where and how to get tested in your area (for example, this is Pennsylvania’s, which includes descriptors and a testing site map). From there, you should notify your health care provider, as some locations may require pre-registration or a doctor’s prescription to receive a test.

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It’s easy to be scared right now with COVID-19 cases and deaths hitting a new peak right around the holidays. That, coupled with the frustration and restlessness of feeling like your normal life is put on pause can worsen the general sense of unhappiness with the current situation. That’s why we need to get control of the pandemic, and testing is one currently among the best strategies we have. When coupled with social distancing and mask-wearing, testing allows us to track where the illness is and help those who have it. Until we have a vaccine, testing allows us to slow the growth of cases, leading to thousands of prevented deaths and illnesses. If you have Medicare, coverage for something so essential, should never be in doubt. Thankfully, Medicare does cover COVID testing, leaving you a little more assured in these uncertain times.