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Does Medicare cover COVID-19 tests, vaccines and treatment?


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​Yes. Even though some COVID-19-related coverage changed after the pandemic’s public health emergency ended in May 2023, Medicare will still pay for coronavirus lab tests, vaccines and many forms of treatment.

But you need to follow special steps to get Medicare coverage or save money. The Centers for Disease Control and Prevention reports that COVID-19 cases are increasing in many states this summer.

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Does Medicare cover COVID-19 tests?

Medicare no longer covers over-the-counter COVID-19 tests, and the government stopped sending out free home tests March 8, 2024, though it’s possible the program will resume in the future. In most cases you must pay for these tests yourself; you can find them at many retail pharmacies.

Medicare Part B continues to cover coronavirus lab tests ordered by a health care provider. This can include polymerase chain reaction (PCR) tests or antigen tests that a laboratory processes. These tests are not subject to the Part B deductible and coinsurance if you have original Medicare and get tested at a pharmacy, clinic, doctor’s office or hospital that takes Medicare.

If you have a Medicare Advantage plan, your coverage may differ.

Even though Medicare doesn’t cover retailers’ COVID-19 tests, some Medicare Advantage plans give an allowance for over-the-counter drugs, which you can apply toward the tests. You may have a Medicare flex card to help pay for these expenses. Contact your plan for details. For example, most UnitedHealthcare Medicare Advantage (Part C) plans come with a UnitedHealthcare UCard credit every quarter for covered over-the-counter products, including OTC coronavirus tests.

Medicare Advantage plans must cover COVID-19 lab tests, but some plans charge copayments.

Does Medicare cover COVID-19 vaccines?

After Congress passed the Inflation Reduction Act, Medicare began to cover many vaccines as a free preventive benefit with no cost-sharing. Medicare Part B covers the COVID-19 vaccine, and providers who participate in Medicare can’t charge beneficiaries for the vaccine.

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Medicare covers the vaccines that the CDC’s Advisory Committee on Immunization Practices recommends, says Juliette Cubanski, deputy director for KFF’s program on Medicare policy. The Washington-based nonpartisan group studies health policy issues. 

Coverage is based on the vaccine type, who needs it, and the frequency the CDC recommends, she says. 

Medicare Advantage plans must also cover COVID-19 vaccines as a free benefit if you use a provider in the plan’s network. You may have a copayment if you go out of network.

For example, Aetna Medicare Advantage PPOs make the vaccine available to members at no cost, regardless of an in-network or out-of-network provider. Under an Aetna Medicare Advantage HMO, the vaccine is available to members at no cost only when using a network provider. Humana provides similar coverage.

Does Medicare cover COVID-19 treatment?

Some prescription treatments can help prevent a mild case of COVID-19 from becoming severe. Widespread access to free COVID-19 treatments is no longer available, but there are strategies for getting coverage or reducing costs.

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Paxlovid, the most commonly used antiviral, will continue to be free through 2024 for people with Medicare or Medicaid because of a federal patient assistance program from drugmaker Pfizer. Patients with a Paxlovid prescription can enroll in the assistance program online or by calling 877-219-7225.

People with Medicare Part D can use their prescription drug plans to help pay for oral antiviral COVID-19 treatments, including Paxlovid and Lagevrio. Out-of-pocket costs vary by plan. Several Part D plans cover Paxlovid with no copayments for 2024, including Aetna, Humana and UnitedHealthcare.

You may not need to go to a doctor to get a Paxlovid prescription. Eligible pharmacists in most states, including those at CVS and Walgreens, can prescribe Paxlovid.

If you test positive for COVID-19 at Walgreens, or provide proof of a positive result, such as an in-home test, you can have a clinical assessment with a pharmacist over the phone. CVS patients can complete the digital eligibility screener on CVS.com or the CVS Pharmacy app for a phone-based clinical assessment with a pharmacist.

Veklury (remdesivir) is a COVID-19 antiviral treatment administered intravenously at a medical facility, rather than as a prescription pill, so Medicare Part B rather than Part D covers it. You may have to pay the Part B deductible and 20 percent coinsurance, but a Medigap plan or other supplemental policy may shoulder the costs.

Keep in mind

Medicare no longer covers over-the-counter COVID-19 tests. But if you have a health savings account (HSA) or flexible spending account (FSA), you can use tax-free money to pay for COVID-19 tests and other out-of-pocket costs to help detect and protect you from COVID.

“Thanks to the passage of the CARES Act, in 2020, individuals can also buy a wide variety of over-the-counter medications to help treat the symptoms of COVID, such as pain and fever medications, cough and cold medicines, decongestants and more,” says Rachel Rouleau, chief compliance officer of Health-E Commerce, which runs HSAstore.com and FSAstore.com, websites that sell HSA- and FSA-eligible drugstore items. “Digital thermometers and pulse oximeters are also eligible with tax-free FSA and HSA funds.”

Even though you can’t contribute to an HSA after you enroll in Medicare, you can withdraw money tax-free from the account to pay for out-of-pocket medical expenses at any time.

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