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CMS Begins Coverage of OTC COVID-19 Tests for Medicare Beneficiaries

NEW YORK – The Centers for Medicare and Medicaid Services announced on Monday that people with Medicare Part B, including those enrolled in Medicare Advantage plans, can now access free over-the-counter COVID-19 tests.

Beneficiaries can get up to eight OTC COVID-19 tests per month from participating pharmacies and healthcare providers, the agency said in a statement. The agency previously announced its plan to cover OTC tests for its beneficiaries in February. Medicare Part B covers medically necessary and preventive services, including clinical research, mental health care, ambulance services, and some outpatient prescription drugs. 

The initiative enables payment from Medicare directly to eligible pharmacies and healthcare providers, it added. Providers and suppliers that are eligible to participate include certain types of pharmacies and other healthcare providers who are enrolled in Medicare and able to provide ambulatory healthcare services such as preventive vaccines, COVID-19 testing, and regular medical visits.

The agency isn't requiring participating pharmacies and providers to go through any new Medicare enrollment processes. If a healthcare provider currently offers ambulatory health care services to Medicare patients, then it is eligible to participate, CMS said.

Multiple national pharmacy chains are participating, including Albertsons Companies, Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid, Shop and Stop, Walgreens, and Walmart. 

CMS has required state Medicaid programs, health insurers, and group health plans to reimburse for OTC COVID-19 tests since December. 

"With today’s step, we are further expanding health insurance coverage of free over-the-counter tests to Medicare beneficiaries, including our nation’s elderly and people with disabilities," US Department of Health and Human Services Secretary Xavier Becerra said in a statement.