CMS rolls out free at-home COVID-19 tests for Part B, Medicare Advantage beneficiaries

Medicare beneficiaries in Part B can now get at-home COVID-19 tests from participating pharmacies and providers.

The Centers for Medicare and Medicaid Services announced Monday that beneficiaries can get up to eight at-home tests at participating pharmacy chains such as CVS, Rite Aid, Costco and Walmart and other providers, a few months after the Biden administration required private insurers to reimburse customers for tests. 

“This is all part of our strategy to ramp up access to easy-to-use, at-home tests free of charge,” said Health and Human Services Secretary Xavier Becerra in a statement Monday.

This is the first time that Medicare has covered an over-the-counter, at-home test.

The reason for the move is that testing is “a critical part of our pandemic response,” said Meena Seshamani, director of the Center for Medicare at CMS in a statement. 

CMS has allowed providers and suppliers that are already enrolled in Medicare and can furnish ambulatory healthcare services like vaccines and regular medical visits to participate. 

“To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and healthcare providers to go through any new Medicare enrollment process,” the agency said in a release. “If a healthcare provider currently provides ambulatory healthcare services such as vaccines, lab tests or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.”

The eligibility extends to beneficiaries that have Medicare Part B, including those that are in Medicare Advantage (MA). For those beneficiaries in MA, the tests covered will be outside of their plan’s coverage. 

The program will be available until the end of the Public Health Emergency, which is expected to be extended through this summer.

The decision drew plaudits from the insurer advocacy group AHIP, which said that the decision can help “ensure equitable access to tests and treatment, and to support continued vigilance as we work together to end the pandemic.”

CMS’ move comes several months after President Biden announced that all Americans can order four free at-home tests off an administration website. The administration also required private insurers to reimburse any purchased tests.

However, lawmakers and advocates complained that the moves didn't affect Medicare's population, which can be vulnerable to the virus. Some lawmakers called for the administration to make similar moves to address at-home tests for beneficiaries.