The End of the Public Health Emergency and Medicare Coverage
For many, the most straightforward way to receive a free COVID-19 test during the pandemic was through federal programs that provided mail-order at-home tests. The Centers for Medicare & Medicaid Services (CMS) also provided a temporary demonstration program that allowed Medicare beneficiaries to get up to eight free over-the-counter (OTC) tests per month from participating pharmacies. However, this period of readily available, no-cost at-home testing came to a close with the end of the Public Health Emergency (PHE).
This shift means that the temporary policies have expired, reverting coverage rules to pre-PHE standards. For senior citizens, this is a critical distinction, as it affects how they can get tested and what they might have to pay out-of-pocket for. It is important for beneficiaries to understand that different rules now apply to different types of COVID-19 tests.
Accessing Covered Laboratory-Conducted COVID-19 Tests
While coverage for at-home tests has lapsed, Original Medicare still covers medically necessary, laboratory-conducted COVID-19 tests when ordered by a healthcare provider. This ensures that seniors who require testing for medical reasons can continue to do so without worrying about cost-sharing.
What to Expect with Lab-Conducted Tests
To get a covered lab-conducted test:
- Consult a healthcare provider: You must have a doctor or other qualified health practitioner order the test, confirming it is medically necessary.
- Go to an approved facility: The test must be performed at a laboratory or a doctor's office, not at home.
- No out-of-pocket costs: For a medically necessary test, Original Medicare covers the cost fully, meaning there is no deductible, coinsurance, or copayment for the patient.
This pathway ensures that critical testing remains accessible for seniors, particularly for those with symptoms or exposures where clinical guidance is needed.
The Role of Medicare Advantage Plans
Unlike Original Medicare, Medicare Advantage (MA) plans, also known as Part C, are offered by private companies and can provide different coverage for healthcare services. While MA plans must cover all services offered by Original Medicare, they may offer additional benefits, including over-the-counter (OTC) test coverage.
To find out if your MA plan covers at-home tests:
- Review your plan documents: Check your Evidence of Coverage or Annual Notice of Change for details on supplemental benefits.
- Contact your plan provider: Call the number on your insurance card to inquire directly about any coverage for OTC COVID-19 tests.
Coverage under MA plans can vary widely, and some may have different cost-sharing rules than Original Medicare. Always check with your specific plan to confirm what is included.
Alternative Sources for Free Testing
Even with changes to federal and Medicare policies, free COVID-19 tests are not entirely a thing of the past. Several resources are available for seniors who need tests but do not want to or cannot pay for them out-of-pocket.
- Local Health Departments: Public health departments often receive federal or state funding to provide free testing to their communities. They may operate testing sites or distribute at-home kits.
- Community Health Centers: These centers provide care regardless of a person's ability to pay and often have free or low-cost testing options.
- Testing Locators: The Centers for Disease Control and Prevention (CDC) or other health organizations may offer online tools to help you find nearby testing locations. Check the HHS COVID-19 Testing Information website for potential resources.
- Assistance Lines: For seniors and people with disabilities who need help navigating testing options, hotlines like the Eldercare Locator or the Disability Information and Access Line (DIAL) can provide guidance.
OTC vs. Lab-Conducted Tests: A Comparison for Seniors
| Feature | Over-the-Counter (OTC) Tests | Laboratory-Conducted Tests |
|---|---|---|
| Current Medicare Coverage | Not covered by Original Medicare. May be a supplemental benefit in some Medicare Advantage plans. | Covered by Original Medicare when medically necessary and ordered by a provider. |
| Cost to Senior | Out-of-pocket cost unless covered by a Medicare Advantage plan or found for free elsewhere. | No cost to the senior when covered by Original Medicare. |
| Order Required | No order needed to purchase. | Requires a healthcare provider's order. |
| Test Location | At home or in a designated space. | Doctor's office, clinic, or lab. |
| Result Speed | Typically 15–30 minutes for rapid tests. | May take longer depending on the lab and specific test. |
| Accuracy | Generally less sensitive than lab tests, especially in early infection. | Often considered the gold standard for accuracy. |
Conclusion
While the days of universally free, mail-order at-home COVID-19 tests are behind us, senior citizens still have avenues for free or covered testing. Original Medicare continues to provide full coverage for medically necessary lab-conducted tests ordered by a healthcare provider. Furthermore, proactive seniors can explore supplemental benefits offered by their Medicare Advantage plans or seek out free resources provided by local health departments and community health centers. By staying informed, older adults and their caregivers can ensure they have access to the testing they need for peace of mind and continued health protection.
For those who need assistance navigating these options, support lines like the Eldercare Locator are valuable resources. Staying proactive and informed is key to accessing testing in this new phase of public health.
Frequently Asked Questions
What is the difference between an OTC test and a lab-conducted test?
An OTC (over-the-counter) test is a rapid antigen test that you can purchase and perform yourself at home. A lab-conducted test, such as a PCR test, is administered at a medical facility and processed in a laboratory, offering higher accuracy.
Is there a website to order free tests by mail for seniors anymore?
No, the federal program for ordering free at-home COVID-19 tests by mail, including for seniors, has ended. You can no longer place orders through covid.gov or its previous versions.
What if I have a Medicare Advantage plan?
If you have a Medicare Advantage (Part C) plan, you should contact your plan provider directly. Some MA plans include additional benefits that may cover the cost of over-the-counter COVID-19 tests.
Where can I find a free testing location in my area?
Local health departments and community health centers are the best places to check for free testing sites. You can also search for a nearby testing location on the HHS website or other public health portals.
Does a doctor's order mean the test is automatically free?
For seniors with Original Medicare, a medically necessary lab-conducted test ordered by a doctor is covered at no cost. However, if the test is not ordered by a healthcare provider or is performed outside an approved lab, it may not be covered.
What should I do if my doctor recommends an at-home test?
If your doctor recommends an at-home test, you may need to pay for it out-of-pocket unless you have a Medicare Advantage plan that covers it or you find a free test through a local public health resource.
Can I get help finding testing resources?
Yes, support is available. You can contact the Eldercare Locator at 800-677-1116 for assistance in finding local services and resources for seniors, including information on testing.
Resources and Citations
- HHS COVID-19 Testing Information (April 8, 2025)
- National Council on Aging - COVID Testing and Medicare (September 10, 2025)
- CMS: Medicare COVID-19 Over-the-Counter Tests (November 22, 2024)
- CNET: COVID-19 Tests From USPS Are Over (March 10, 2025)
