Medicare covers most COVID-19 tests at no cost to you

Medicare Part B covers COVID-19 diagnostic tests, antibody tests, and at-home tests without requiring you to pay out of pocket. You do not need a copay, coinsurance, or deductible for these tests when ordered by a doctor or other healthcare provider. This coverage applies whether you get tested at a hospital, clinic, pharmacy, or doctor's office.

The coverage is straightforward: if a healthcare provider orders the test, Medicare pays for it. You show your Medicare card, and that is usually all that is needed. The provider bills Medicare directly, and you walk away with no bill.

Key Takeaways

  • Medicare Part B covers COVID-19 diagnostic tests, antibody tests, and at-home tests with no copay or deductible when ordered by a healthcare provider.
  • You must have a healthcare provider order the test for Medicare to cover it; tests you order on your own without a provider's order are not covered.
  • Coverage includes tests done at hospitals, urgent care clinics, pharmacies, doctor's offices, and other approved locations.
  • At-home tests are covered when you pick them up at a pharmacy or other location after a provider's order, but not when you buy them yourself without a provider involved.
  • If you have a Medicare Advantage plan (Part C), coverage rules may differ slightly, so check with your plan before getting tested.

Where you can get a covered COVID-19 test

You can get a covered test at most places that offer COVID-19 testing. This includes your doctor's office, urgent care clinics, hospital emergency departments, retail pharmacies like CVS and Walgreens, federally may have access to health centers, and some community health centers. Many of these locations do not require an appointment, though calling ahead can save time.

At-home tests are also covered when you pick them up at a pharmacy or other location after your healthcare provider has ordered them. Some pharmacies will give you the tests at the counter after you show your Medicare card and the provider's order. Others may mail them to you. The key is that a provider must order them first.

What counts as a covered test

Medicare covers three types of COVID-19 tests: diagnostic tests (which tell you if you have COVID-19 right now), antibody tests (which show if you had COVID-19 in the past), and at-home tests (rapid antigen tests you use yourself at home). All three are covered with no cost to you when a healthcare provider orders them.

The tests must be FDA-approved or authorized for emergency use. Most tests available at pharmacies and clinics meet this standard. If you are unsure whether a specific test is covered, ask the provider or pharmacist before you take the test.

When you need a provider's order

Medicare only covers COVID-19 tests that a healthcare provider has ordered for you. A provider can be your primary care doctor, a nurse practitioner, a physician assistant, an urgent care doctor, or another licensed healthcare professional. The provider must order the test as part of your care — for example, because you have symptoms, because you were exposed to someone with COVID-19, or because you need a test before a procedure.

Tests you buy on your own at a store or online without a provider's order are not covered by Medicare, even if they are the same test that would be covered with an order. This is an important distinction: the coverage depends on whether a healthcare provider ordered it, not just on the test itself.

How Medicare Advantage plans handle COVID-19 tests

If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your coverage for COVID-19 tests should be the same — no copay, coinsurance, or deductible — but the rules can vary slightly by plan. Some Medicare Advantage plans may require you to use certain pharmacies or testing locations, or they may have a list of approved providers.

Before you get tested, call your Medicare Advantage plan's customer service number (on the back of your card) and ask whether the location where you plan to get tested is in-network. This takes five minutes and prevents any surprise bills. If the location is out-of-network, ask whether the plan will still cover the test at no cost.

What to bring when you get tested

Bring your Medicare card and a photo ID. That is usually all you need. If your healthcare provider has already ordered the test, the provider's office may have sent the order electronically to the testing location, so the staff will have it on file. If not, you may need to show a written order or prescription from your provider.

If you are getting an at-home test, bring your Medicare card to the pharmacy and let the pharmacist know you have a provider's order. The pharmacist can look up the order in the system or you can show a written order if you have one. Once the order is confirmed, you receive the tests at no cost.

If you receive a bill for a COVID-19 test

If a testing location bills you for a COVID-19 test that was ordered by a healthcare provider, do not pay it when ready. Contact Medicare at 1-800-MEDICARE (1-800-633-4227) and report the bill. Medicare can investigate whether the test should have been covered and can work with the provider to correct the billing.

Keep a copy of any bill you receive, along with the date of the test, the location, and the name of the provider who ordered it. This information helps Medicare track down what happened. You can also contact your state's health department or your state's insurance commissioner's office if you believe you were wrongly billed.

Frequently Asked Questions

Do I need a reason to get a COVID-19 test, or can I get one just to check?

A healthcare provider must order the test for Medicare to cover it, but the provider does not need a specific medical reason. You can ask your doctor for a test if you want one, and many doctors will order it. However, a test you order yourself without a provider's involvement is not covered.

Are rapid at-home tests covered the same way as tests at a clinic?

Yes, rapid at-home tests are covered with no cost when a provider orders them. You pick them up at a pharmacy or other location after the order is placed. Tests you buy yourself at a store are not covered, even if they are the same brand and type.

What if my doctor's office does not do COVID-19 testing?

Your doctor can still order a test for you, and you can get it done at a pharmacy, urgent care clinic, or hospital. Ask your doctor to send the order to the location where you plan to be tested, or ask for a written order you can bring with you.

Does my Medicare Advantage plan cover COVID-19 tests differently than Original Medicare?

Coverage should be the same — no copay or deductible — but your plan may require you to use certain locations or providers. Call your plan before you get tested to confirm the location is covered and to avoid any surprises.

Can I get multiple COVID-19 tests covered, or is there a limit?

Medicare covers COVID-19 tests when a healthcare provider orders them. There is no set limit on how many tests you can have, but each test must be ordered by a provider. If you want frequent testing, discuss this with your doctor.