The Biden-Harris Administration announced that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.

“With today’s announcement, we are expanding access to free over-the-counter COVID-19 testing for people with Medicare Part B, including those enrolled in a Medicare Advantage plan. People with Medicare Part B will now have access to up to eight FDA-approved, authorized or cleared over-the-counter COVID-19 tests per month at no cost. This is all part of our overall strategy to ramp -up access to easy-to-use, at-home tests free of charge,” said HHS Secretary Xavier Becerra. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also delivering close to 250 million at-home, rapid tests to send for free to Americans who need them. Under the Biden-Harris Administration’s leadership, we required state Medicaid programs, insurers and group health plans to make tests free for millions of Americans. 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.”

This is the first time that Medicare has covered an over-the-counter self-administered test at no cost to beneficiaries. This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the two sets of four free at-home COVID-19 tests Americans can continue to order from covidtests.gov. National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., 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 Corp., Shop & Stop, Walgreens and Walmart.

“Testing remains a critical tool in mitigating the spread of COVID-19, and we are committed to making sure people with Medicare have the tools they need to stay safe and healthy,” said Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. “By launching this initiative, the Biden-Harris Administration continues to demonstrate that we are doing everything possible to make over-the-counter COVID-19 testing free and accessible for millions more Americans.”

Providers and suppliers eligible to participate include certain types of pharmacies and other health care providers who are enrolled in Medicare and able to furnish ambulatory health care services such as preventive vaccines, COVID-19 testing and regular medical visits. To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes. If a health care provider currently provides ambulatory health care services such as vaccines, lab tests or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.

“For the first time in its history, Medicare is paying for an over-the-counter test,” said Deputy Administrator Dr. Meena Seshamani, Director of the Center for Medicare at CMS. “This is because COVID-19 testing is a critical part of our pandemic response. Combined with the free over-the-counter tests available through covidtests.gov, this initiative will significantly increase testing access for Americans most vulnerable to COVID-19 and will provide valuable information for future payment policy supporting accessible, comprehensive, person-centered health care.”

A list of eligible pharmacies and other health care providers that have committed publicly to participate in this initiative can be found here. Because additional eligible pharmacies and health care providers may also participate, people with Medicare should check with their pharmacy or health care provider to find out whether they are participating.

This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:

• Requesting free over-the-counter tests for home delivery at gov. Every home in the U.S. is eligible to order two sets of four at-home COVID-19 tests.
• Access to no-cost COVID-19 tests through health care providers at over 20,000 testing sites nationwide. A list of community-based testing sites can be found here.
• Access to lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost through Medicare.
• In addition to accessing a COVID-19 laboratory test ordered by a health care professional, people with Medicare can also access one lab-performed test without an order and cost-sharing during the public health emergency.

For more information, please see this fact sheet https://www.cms.gov/newsroom/fact-sheets/medicare-covers-over-counter-covid-19-tests

People with Medicare can get additional information by contacting 1-800-MEDICARE and going to: https://www.medicare.gov/medicare-coronavirus. Medicare also maintains several resources to help ensure beneficiaries receive the correct benefits while also avoiding the potential for fraud or scams. More details—particularly on identifying scams due to COVID-19—can be found at https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse.

Pharmacies and other health care providers interested in participating in this initiative can get more information here: https://www.cms.gov/COVIDOTCtestsProvider

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During April, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) recognizes National Minority Health Month. Officially established by Congress in 2002, this health observance offers an opportunity to build awareness about the health inequities that have historically affected underserved and marginalized communities.

In keeping with Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, our office is working to develop a comprehensive approach to advance equity for all including people of color and those adversely affected by persistent poverty and inequity to ensure those served by CMS can achieve their highest level of health and well-being. This is an effort that has involved furthering and embedding equity work across all CMS programs and continuing to provide resources to encourage advancing health equity for all the populations we serve. From the CMS Innovation Center, to the Medicare program, Medicaid and CHIP programs across the country, the Marketplace team, and more, CMS is committed to advancing health equity across Medicare, the Marketplaces, and Medicaid and CHIP.

This observance exemplifies our goal to help eliminate health disparities while improving the health of all minority populations. Below is a list of the resources offered by CMS OMH in order to help achieve this goal.

Resources

• Review the Health Equity Challenges and CMS Resources to Help Address Them infographic, which outlines various barriers to health equity and related challenges that populations often face and shares CMS resources that can help close the health equity gap.
• Review the Health Equity Technical Assistance Program which offers resources aimed at helping health care organizations take action against health disparities.
• Use the Mapping Medicare Disparities Tool to identify areas of disparity between subgroups of people with Medicare (e.g., racial and ethnic groups) in health outcomes, utilization, and spending.
• Download Improving Health in Rural Communities: 2021 Year in Review to learn about the activities and accomplishments that CMS has made in improving the health and wellbeing of individuals living and working in rural, frontier, and tribal communities in fiscal year 2021.
• Download Paving the Way to Equity: A Progress Report to learn more about the progress CMS has made in advancing health equity between 2015 and 2021.
• View our Coverage to Care initiative, which was developed to help people understand their health coverage and connect to the primary care and preventive services that are best for them.

The Biden-Harris Administration is announcing that as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy thanks to the American Rescue Plan (ARP). Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administration’s latest effort to address the nation’s crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.

In addition to related updates in the 2023 federal budget request, for example, in December 2021, Vice President Kamala Harris hosted the first-ever federal Maternal Health Day of Action, where she announced a call to action to both the public and private sectors to help improve health outcomes for parents and infants in the United States. Today’s announcements are a part of the Biden-Harris Administration’s continued response to that call to action to support safe pregnancies and childbirth, and reduce complications and mortality in the year following birth.

“Having postpartum care can be life-saving and lead to better long-term health outcomes for new parents and newborns,” said Health & Human Services (HHS) Secretary Xavier Becerra. “Thanks to President Biden’s American Rescue Plan, we are able to make it easier for states like Louisiana to give thousands more pregnant and postpartum people across the country access to high-quality, affordable coverage for the essential first year after birth. The Biden-Harris Administration has made maternal health and equity a priority, and we are working to ensure every parent has access to the care they and their child deserve.”

Louisiana, the first state CMS is approving to take advantage of this new state plan opportunity under the ARP, today began offering its enhanced coverage to an estimated 14,000 pregnant and postpartum people. CMS is also working with an additional nine states to extend postpartum coverage. In 2021, Illinois, New Jersey, and Virginia were the first states to use Medicaid demonstration authority to provide 12 months of continuous postpartum coverage for all Medicaid and CHIP enrollees. In addition, a number of other states have announced that they are working to extend Medicaid coverage to 12 months after pregnancy, and CMS looks forward to working those states. In order to receive federal funds and to ensure consistency with federal standards, including those set by the ARP, states must go through a formal process run by CMS.

“This is an historic step for states to partner with us to provide life-saving coverage for postpartum people—and meaningfully address the maternal health crisis. For too long, families have been left behind by a health care system that breaks connections to care when they are needed most,” said CMS Administrator Chiquita Brooks-LaSure. “Everyone deserves an opportunity to attain and maintain health. The American Rescue Plan created a pathway to connect pregnant people to vital health coverage through that first critical year after birth, and I urge every state to adopt this option to extend lifesaving postpartum coverage.”

Under existing requirements, many Medicaid and CHIP enrollees receive coverage through the end of the month in which their 60-day postpartum period ends. Maintaining Medicaid and CHIP coverage for a full year provides access to critical health care services during the first year after pregnancy, which can help to address persistent health disparities. One-third of maternal deaths occur between one week to a year after the end of pregnancy, and rates of maternal mortality are up to five times higher among Black and American Indian/Alaska Native people than their white peers.

Beginning April 1, 2022, the ARP’s new state plan option offers state Medicaid and CHIP agencies an opportunity to provide 12 months of continuous postpartum coverage. States choosing to extend postpartum coverage must elect this option in both Medicaid and their separate CHIP programs, if applicable, and submit required state plan amendments to CMS. The new ARP state plan option is currently limited to a five-year period that ends on March 31, 2027.

States like Louisiana that adopt the new extended postpartum coverage must provide coverage to all eligible individuals who were enrolled in Medicaid or CHIP while they were pregnant. This extended coverage period will last from the day the pregnancy ends through the end of the month in which their 12-month postpartum period ends.

The postpartum coverage option extends to current beneficiaries who are enrolled in Medicaid or CHIP while pregnant but are no longer pregnant when the state implements the ARP option, if the individual is within their 12-month postpartum period when their state implements the option. It also applies to individuals who were pregnant at some point during the three months prior to applying for Medicaid, if they met the eligibility requirements at that time.

Advancing this state plan option comes at a critical time for pregnant individuals and families, many of whom are relying on continued Medicaid and CHIP coverage for the ongoing care they need during the postpartum period. Continuity of coverage can help postpartum people manage chronic conditions, like hypertension and diabetes, that last well beyond the first 60 days postpartum, as well as provide access to behavioral health and other mental health care services.

Other states interested in learning about extending postpartum coverage through the ARP can contact their CMS state lead or consult the state health official letter CMS issued in December 2021.