Does Medicaid Cover COVID-19 Testing?

In this article...
  • Does Medicaid cover COVID-19 testing? Federal guidelines are in place for Medicaid enrollees who need help getting tested for COVID. Find out what's covered.

Medicaid is a joint federal-state health insurance program that principally offers coverage to Americans with limited income and assets. More than 75 million people participate in the Medicaid program, which is available in all 50 states and several territories, including the District of Columbia. Since their development for COVID-19 in 2020, hundreds of millions of tests have been administered at an average cost of between $36 and $143 each. Even at the low end, these prices can be a burden for people whose income is low enough to qualify for Medicaid. Find out if Medicaid pays for COVID-19 testing below.

Does Medicaid Cover COVID-19 Testing?

Part of the federal response to the COVID-19 pandemic has been to assign responsibility for the cost of testing to Medicaid for all qualified program participants. This payment directive runs throughout the period of the public emergency and ends on the last day of the quarter following the last day of the emergency period. Thus, for the duration of the pandemic emergency, and for at least a year after it ends, Medicaid is required to pay for most of its beneficiaries' COVID-19 tests.

Are COVID-19 Tests Free?

While Medicaid does cover COVID-19 tests for most beneficiaries, there are limits. The emergency coverage doesn't extend to beneficiaries who have limited Medicaid coverage for specific conditions. Beneficiaries who are enrolled in a short-term, limited-duration plan are not guaranteed coverage for their tests, but states may extend testing coverage to these enrollees on a voluntary basis. 

If you don't have Medicaid benefits or you don't qualify, you will need to pay out-of-pocket for the test. However, many organizations and local agencies, including public libraries, are offering tests for free to the community.

Medicaid Benefits for COVID-19

Procedures related to COVID-19 generally fall into three categories: testing, treatment and vaccinations.

  • Testing: The CARES Act mandates that all public and private health insurance plans provide full coverage for coronavirus testing for the duration of the pandemic emergency. Providers are not allowed to restrict testing by requiring preapproval or other limitations, and tests can be made available for any purpose, including personal treatment, public health monitoring and employment-related screenings. 
  • Treatment: No special provisions have been enacted to cover the cost of COVID-19 treatments. Medicaid benefits include necessary treatments for coronavirus infections in exactly the same way they previously paid for other necessary medical expenses. 
  • Vaccinations: Medicaid is required to pay for the cost of COVID-19 vaccinations without any additional expense or cost-sharing requirements.

Where Can I Get a COVID-19 Test?

Where you can get a COVID-19 test varies depending on where you live. Tests are available at most hospitals and urgent cares, but testing may be limited to those who are showing symptoms due to test kit shortages. You may need to get a referral for a test from your health care provider before going in.

Some drug stores offer drive-through testing at certain times or on certain days, and you may also be able to buy a COVID-19 test at the store if they're available in your area.

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