Medicare Part B covers molecular, antigen, and antibody coronavirus testing from Medicare-approved labs. Medicare does not cover over-the-counter home test kits.
Various tests can detect COVID-19, the illness caused by the novel coronavirus SARS-CoV-2. Viral tests, like molecular and antigen tests, can detect a current infection. Antibody tests can determine whether you’ve previously contracted the novel coronavirus.
Medicare Part B covers molecular, antigen, and antibody tests for COVID-19. Medicare also covers tests for related respiratory conditions that may be done together with a COVID-19 test.
This article reviews the COVID-19 tests covered by Medicare.
Doctors use molecular tests to diagnose a current infection with the novel coronavirus, which is the illness that causes COVID-19. These tests are considered the “gold standard” for diagnosing COVID-19, with research showing
Healthcare professionals usually take samples via a nasal or throat swab. Occasionally, they also use a saliva sample. Turnaround time can vary from
Medicare Part B (medical insurance) covers molecular diagnostic tests for COVID-19 if:
- your Medicare-enrolled doctor orders it and you get the test in a lab or hospital that takes Medicare
Similar to molecular tests, doctors use antigen tests to determine whether you currently have COVID-19.
Antigen tests work by looking for viral markers called antigens. If the tests detect novel coronavirus antigens, the antibodies used in the test will bind to them and produce a positive test result.
Doctors collect samples for the test using a nasal swab. The turnaround time for an antigen test is usually faster than a molecular test. You may receive results in
Medicare Part B will cover a Food and Drug Administration (FDA)-approved antigen COVID-19 diagnostic test if:
- your Medicare-approved doctor orders it and the test is done in a lab or hospital that takes Medicare
Antibody tests can determine whether you’ve previously had COVID-19. The test requires a blood sample that a healthcare professional will take from a vein in your arm or through a fingerprick.
The test looks for antibodies in your blood sample that are specific to the novel coronavirus. Antibodies are proteins that your immune system creates in response to infections or vaccinations.
It usually takes 1 to 3 weeks for your immune system to begin producing antibodies. That’s why antibody tests are not used to diagnose a current infection.
Medicare Part B will cover an FDA-authorized coronavirus antibody test if:
- your Medicare-approved doctor orders it and the test is done in a lab or hospital that takes Medicare
Some (but not all) of the FDA-approved coronavirus antibody tests include:
- Abbott Alinity i SARS-CoV-2 IgG
- Abbott Architect SARS-CoV-2 IgG
- Autobio Anti-SARS-CoV-2 Rapid Test
- Cellex qSARS-CoV-2 IgG/IgM Rapid Test
- EUROIMMUN Anti-SARS-CoV-2 ELISA (IgG)
- Roche Elecsys Anti-SARS-CoV-2
Check with your doctor to make sure the antibody test you’re getting is FDA approved and the lab performing the test is Medicare approved.
If you aren’t sure where to get a Medicare-approved coronavirus antibody test in your area, contact your local health department. They could help provide information about testing sites. You can also contact Medicare at 800-MEDICARE (800-633-4227).
Over-the-counter (OTC) COVID-19 diagnostic tests can determine whether you have an active COVID-19 infection. These tests are FDA-authorized and do not require a prescription.
Test kits are typically available at your local pharmacy. You can collect your own sample via a nasal swab, perform the test, and get the results in about 15 minutes without having to send your sample to a lab.
Medicare does not cover OTC home testing kits for COVID-19. However, as of
To obtain your free test kits, visit www.covidtests.gov.
Does Medicare cover COVID-19 vaccines?
Yes. Original Medicare covers the updated (2023 to 2024) Moderna or Pfizer-BioNTech COVID-19 vaccine.
You’ll pay nothing for the vaccine if your Medicare-approved doctor orders the vaccine.
You can use this online link to find a COVID-19 vaccine near you. Bring your red, white, and blue Medicare card with you when you get the vaccine so your healthcare professional or pharmacy can bill Medicare.
Original Medicare covers molecular, antigen, and antibody diagnostic tests for COVID-19 based on specific criteria. Coverage is provided if your Medicare doctor orders the test, it is FDA approved, and it is performed at a Medicare-approved lab.
Original Medicare also covers vaccines for COVID-19.
Talk with your doctor or contact Medicare directly at 800-MEDICARE (800-633-4227) if you’re unsure whether your COVID-19 test or vaccine is covered.