Advocacy Organizations Urge Better Medicare Coverage of COVID-19 Services

This week, Medicare Rights joined with Justice in Aging and 65 other advocacy groups in a letter to urge the Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to expand access to at-home COVID-19 tests and COVID-19 vaccine boosters for people with Medicare. This includes urging the administration to extend coverage of at-home over-the-counter (OTC) COVID-19 testing with no cost-sharing to all people with Medicare, including people with limited English proficiency; providing additional guidance for states to help their Medicaid populations; and building upon the previous action and increase COVID-19 vaccine boosters and additional doses for people with Medicare.

HHS recently announced requirements for insurance companies to cover eight OTC at-home COVID-19 tests per person per month without cost-sharing, but in a frequently asked questions document, the department explained that this policy does not extend to people with traditional Medicare, saying only that “At this time Original Medicare cannot pay for at-home tests through this program.” Medicare Advantage plans are permitted but not required to cover the tests.

Currently, Medicare beneficiaries can use only laboratory testing. This is an obstacle, especially for those who lack reliable transportation. Because many people with Medicare are at increased risk of serious illness and death from COVID-19, we must continue to reduce barriers to access testing to advance both their individual well-being and public health. We urge CMS to provide Medicare coverage of OTC COVID-19 tests as soon as possible.

Medicaid enrollees might also find accessing at-home tests difficult. States must cover such tests with no cost-sharing, but states need additional federal guidance on how Medicaid beneficiaries can have their tests compensated without the need for reimbursement.

Everyone, including people with Medicare, can request free at-home testing kits free-of-charge to people who request them through the website (COVIDtests.gov) or the hotline (1-800-232-0233). This hotline includes multiple language access services to help ensure hold times are not a barrier for people with limited English proficiency.

We also continue to urge the administration to prioritize individuals who are homebound and those in congregate settings for vaccines and boosters. In addition, we ask for clearer guidance for many people who are high risk or immunocompromised as to whether and when they should be getting additional doses, especially for those who received the Johnson & Johnson vaccine.

Read the letter.

Request free at-home tests through COVIDtests.gov or by calling 1-800-232-0233.

Read more about at-home tests.