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February 4, 2022

Medicare will (finally) cover at-home Covid-19 tests

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    CMS on Thursday announced that Medicare and Medicare Advantage beneficiaries will soon be able to get up to eight at-home Covid-19 tests per month for free—a move that comes weeks after private insurers were required to cover the tests, and after Democratic senators called on the agency to make Covid-19 tests more accessible.

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    Details on the plan

    According to a press release from CMS, Medicare and Medicare Advantage beneficiaries will be able to acquire their at-home Covid-19 tests through "eligible pharmacies and other participating entities."

    "This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries," CMS noted in the release.

    "There are a number of issues that have made it difficult to cover and pay for over-the-counter Covid-19 tests. However, given the importance of expanding access to testing, CMS has identified a pathway that will expand access to free over-the-counter testing for Medicare beneficiaries," CMS said in the release. "This new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost."

    CMS didn't provide a start date for the initiative, but it said it "anticipates that this option will be available to people with Medicare in the early spring."

    Under guidance previously released by HHS, private insurers have been required to cover the cost of at-home rapid tests since mid-January—but that requirement did not apply to Medicare.

    Reaction

    The announcement comes after a group of eight Democratic senators called on CMS to make at-home Covid-19 tests more accessible to seniors in an open letter sent last week to HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure.

    The policy of not covering at-home Covid-19 tests for Medicare beneficiaries "leaves them on the hook for potentially significant out-of-pocket costs," the senators wrote. "We share your commitment to making sure Medicare enrollees receive the highest quality health care, including access to free at-home rapid Covid-19 testing, and look forward to working with you to address this issue."

    Sen. Richard Blumenthal (D-Conn.), who was one of the authors of the letter, sent a separate letter to Brooks-LaSure last week "urgently call[ing]" on CMS to "make Covid-19 tests more accessible to all who need them."

    "A critical step in this effort is expanding free coverage of [over-the-counter] at-home Covid-19 tests to individuals with Medicare coverage," Blumenthal added.

    Sen. Debbie Stabenow (D-Mich.), who was one of the authors on the letter sent to Becerra and LaSure, praised CMS' announcement.

    "This is important news that will make a big difference in keeping people safe," she said. "Because of our work, now the millions of Americans on Medicare will be able to receive free rapid Covid-19 tests. I appreciate the Biden administration stepping up to work with us on this important development."

    AARP, who also sent a letter to Becerra last week asking that HHS make at-home Covid-19 tests free to Medicare beneficiaries, similarly praised CMS' announcement.

    "The cost of paying for tests and the time needed to find free testing options are barriers that could discourage Medicare beneficiaries from getting tested, leading to greater social isolation and continued spread of the virus," Nancy LeaMond, AARP's EVP, said. "We are pleased that CMS listened to our concerns and found a path forward to cover over-the-counter tests for seniors." (CMS press release, 2/3; Frieden, MedPage Today, 2/3; Frieden, MedPage Today, 1/25; Lim/Levy, Politico, 2/3)

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