Medicare says California seniors will be able to get at-home COVID-19 tests at drugstores
By early spring, Medicare will allow California seniors to go to their local drugstores to get up to eight home tests for COVID-19 each month at no cost, rather than requiring them to check to see if their insurers will reimburse them, federal officials announced Thursday.
It’s the first time that Medicare would be paying for an over-the-counter test for free, according to the U.S. Centers for Medicare and Medicaid Services.
Currently, seniors on the original fee-for-service Medicare cannot get home tests covered, and those who had Medicare Advantage coverage had to check whether their insurance plans would reimburse them for home tests they purchased.
Davis resident Suzanna De Palma, 74, called The Bee in frustration last week, saying that United Healthcare had told her that the federal government wouldn’t allow them to reimburse people. Palma had a bout of COVID-19, and at the end of her quarantine period she wanted to test to see if the virus was still present.
“If the president said that insurance companies should reimburse, then insurance companies should reimburse,” said De Palma, who was an emergency room nurse at UC Davis Medical Center before she retired. “There should be no restriction. There should be no fine print where you can only get a test...if you jump through a bunch of hoops. It should be that anybody who purchases a test to keep themselves safe...should be reimbursed by their insurance.”
President Joe Biden’s order, issued Jan. 10, specified that “individuals with private health insurance coverage or covered by a group health plan” would receive a reimbursement, but noted that people enrolled in a Medicare Advantage plan should check with their plan to see if it covers at-home over-the-counter COVID-19 tests.
“The guidelines for at-home testing released by the Biden Administration are for commercial health plans only,” said Tracey Lempner, a spokesperson for United Healthcare. “They do not cover Medicare Advantage plans.”
Lempner added that all of United Healthcare’s Medicare Advantage plans cover COVID-19 testing when ordered by a physician and there is no copay.
De Palma, who works part-time with a hospice program, said it can be several days before patients have results from the physician-ordered tests.
“The home test is so immediate,” she said, “and people can test themselves before...they have people over and then after they have people over. So the test should be in everybody’s hands.”
De Palma was able to get two tests from Yolo County, she said, and ordered more online. She said the U.S. Centers for Medicare & Medicaid Services is taking a step in the right direction by making the at-home COVID-19 tests available over the counter.
“I am happy that Medicare is going to be able to put the tests in people’s hands and you don’t have to jump through a bunch of hoops,” she said.” You just go to the drugstore and it’s handled for you like medications are.”
In its statement, CMS officials noted that beneficiaries must go to an eligible pharmacy or other participating entity and purchase one of the tests approved or authorized by the U.S. Food and Drug Administration.
Some Medicare Advantage providers will continue to reimburse for the tests or provide them, the CMS statement noted, and Medicare beneficiaries can order four at-home tests at covidtest.org.
Seniors are among the most vulnerable to COVID-19, De Palma said, and they should be able to get these tests easily to determine whether they’re infected.
This story was originally published February 4, 2022 at 3:00 AM.
