Rapid COVID-19 Tests Aren't Free to Some People Who Might Need Them the Most

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  • Beginning in January, private insurance companies must reimburse enrollees for the cost of rapid COVID-19 tests.
  • That rule does not apply to Medicare, and it's leaving many seniors in the lurch.

Talk about not making sense.

For many months now, Americans have been spending a small fortune on rapid COVID-19 tests. Although lab PCR tests are still considered the most accurate in detecting COVID-19, rapid tests are said to be a reasonable alternative, especially among those who are symptomatic. And while rapid tests have been difficult to come by, in some cases, they're an easier way to test.

This especially holds true for older Americans, many of whom are at a greater risk of complications from COVID-19 due to their aging immune systems. For older patients, rapid tests spare them the risk of having to visit an urgent care center, where the potential for COVID-19 exposure exists. Since these tests deliver results on the spot (whereas lab tests can take days to come back), they offer physicians an opportunity to treat patients immediately to potentially promote better outcomes.

The problem with rapid tests, though, is they can be very expensive, costing $20 to $30 or more for a pack of two. The benefit of lab tests is they're at least free, regardless of insurance carrier or status (meaning, those without insurance don't pay, either).

But thanks to a recent change, health insurers are now required to reimburse enrollees for the cost of rapid COVID-19 tests for the first time during the pandemic. That rule, however, does not apply to those on Medicare. That means seniors -- many of whom live on a fixed income -- will have to continue bearing the cost without assistance.

Leaving seniors out in the cold

Many seniors rely heavily on limited income from Social Security and don't have much savings to fall back on. The fact that Medicare enrollees aren't eligible for rapid test reimbursements makes little sense.

When asked why Medicare enrollees can't get reimbursed, the Centers for Medicare and Medicaid Services said since Medicare is willing to pay for lab tests, it doesn't feel the need to reimburse for rapid tests. It's also worth noting that while original Medicare isn't covering rapid COVID-19 tests, some Medicare Advantage plans are.

Medicare Advantage plans are those offered by private insurers as an alternative to original Medicare. But enrollees will need to check their specific benefits to see if they're entitled to reimbursement, as the rules can differ from plan to plan.

Another way to test at home for free

While Medicare may not be picking up the tab for rapid COVID-19 tests, thanks to a new initiative from the Biden Administration, all U.S. households are eligible for a set of four free rapid tests delivered by the U.S. Postal Service. Medicare enrollees can order their free tests through the USPS website; their estimated ship date is late January.

Of course, some seniors may need more than four rapid tests per household, especially as the omicron surge continues its spread. In that case, it's worth looking to see if there are free rapid testing options available locally. Pop-up testing sites may offer rapid tests with or without lab tests, and that could be a more affordable way for Medicare enrollees to get the answers they need.

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