Medicare and COVID-19 Tests: A Guide for Older Adults

COVID-19 testing continues to be a powerful tool for containing the spread of the virus and getting back to doing the things we love. But for older adults, the constantly changing recommendations around testing can feel overwhelming. This guide is designed to help you determine when and where to get tested—and what to do if you test positive for SARS-CoV-2, the virus that causes COVID-19.

Original Medicare continues to cover COVID-19 tests with no cost-sharing (no deductible, coinsurance, or copayment) when the test is ordered by a physician or other health care practitioner. Original Medicare does not cover over-the-counter (OTC) at-home tests as of May 11, 2023.

Medicare Advantage Plans must continue to cover COVID-19 PCR and antigen tests, but costsharing may apply. A beneficiary should contact their plan to learn more about costs and to find out if at-home tests are covered.

But first, it’s important to understand the different types of COVID-19 tests used to detect an active infection.

What are the two main types of COVID-19 tests for seniors?

PCR (polymerase chain reaction) test: The PCR test was the first created to detect active COVID-19 infections, and it's still the most widely used today due to its high accuracy rate. Samples are most often collected via a swab inserted into the nose, which is then sent to a laboratory. The turnaround time for PCR test results can vary from one day to up to a week.

Antigen tests (or "rapid tests"): COVID-19 antigen tests are used at testing sites and are available over-the-counter for home use. Like the PCR test, samples are collected via a nasal swab. The sample is processed through a small cartridge, similar to a home pregnancy test, and the results can be viewed within 15 minutes. Antigen tests are considered less sensitive than PCR tests and are more likely to produce false negative results. However, in people with COVID-19 symptoms, they can be a useful tool for confirming a current infection.

When should you get tested for COVID-19?

According to the Centers for Disease Control and Prevention (CDC), you should get tested if you:

• Have symptoms of COVID-19.
• Have had close contact with someone who has COVID-19 (You should get tested at least 5 days after your last close contact with that person. The date of the last close contact is considered day 0).
• Are not vaccinated for COVID-19, and you’ve been identified for expanded community screening for the virus.
• Are not fully vaccinated for COVID-19, and you’ve been asked to get tested by your school; workplace; health care provider; or state, tribal, local, or territorial health department.

What about testing before travel? If you're exhibiting signs of illness, of course, it’s best to stay home. If you're feeling well, be sure to plan ahead by checking the testing requirements of your airline and your destination.

Where can seniors find free COVID-19 tests?

With the end of the declaration of a Public Health Emergency, free or low cost rapid tests are no longer available to the general public. The U.S. government is continuing to make COVID-19 tests available to uninsured individuals and underserved communities through existing outreach programs. Please contact a HRSA health center, Test to Treat site, or ICATT location near you to learn how to access low- or no-cost COVID-19 tests provided by the federal government.

Some other options are:

• Check with your local health department on where free or low costs tests are available.
• FastLab (depending on your insurance coverage, you may qualify for free at-home testing)
• Some online companies, such as iPromo, sell at COVID home tests in bulk at lower prices than retail.
• Check out the CDC testing locator.  You can search by ZIP code to find locations that offer no cost COVID-19 testing, but these are not the rapid tests.
• Medicare beneficiaries can get free lab tests for COVID-19 when it is ordered by a health care provider and the test is done at a laboratory, e.g., PCR. Medicare does not cover the costs of rapid home tests.

COVID-19 testing options include:

• Local pharmacies.  If you don't have Medicare, many pharmacies have partnered with state and local governments to offer fast, convenient COVID-19 testing for seniors. These include large chains like CVS Health and Walgreens as well as local, independent pharmacies. Call your nearest pharmacy or visit their website to learn more about what they offer.
• Access to COVID-19 tests through health care providers at over 20,000 testing sites nationwide. The U.S. Department of Health and Human Services offers this searchable database of community-based testing sites.
• Access to lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, physician assistant, pharmacist, or other authorized health care professional at no cost through Medicare.

• Community health centers: Your local health center can be a convenient way to get COVID-19 testing. They'll handle the work of determining if your health insurance plan covers the cost of testing and whether there are any out-of-pocket costs. Find a health center near you.
• Urgent care clinics: Beyond treating minor illnesses and injuries, many urgent care centers offer COVID-19 testing for seniors. Some allow you to conduct a virtual or phone visit with a provider first. If they determine you need to get tested, they’ll help you book an appointment. Be sure to call ahead to inquire about testing procedures before you visit your local clinic.

You’ve tested positive for COVID-19. Now what?

According to the latest guidance from the CDC, if your PCR or rapid test comes back positive—regardless of your vaccination status—you should isolate from other people. This guidance also applies if you’re awaiting test results or if you have COVID-19 symptoms (particularly if you’ve had recent close contact with someone who has COVID-19).

What does it mean to isolate? Isolating for COVID-19 means staying home until it’s safe for you to be around other people. You should do so for at least 5 full days. Day 0 is the day your symptoms started. If you’re asymptomatic (without symptoms), Day 0 is the day you received your positive test result.

During isolation, you should:

• Monitor your symptoms. Seek medical attention immediately if you experience trouble breathing or other warning signs.
• Separate yourself from other household members as much as you can, including pets. Use a separate bathroom if you are able to. Don’t share personal items like eating utensils, cups, and towels.
• Ventilate your home as much as possible (e.g., open windows if weather permits).
• Wear a well-fitting mask when you can’t avoid other people in your house.

If your symptoms are improving and you’ve been fever-free for 24 hours by the end of the 5-day period, you can end isolation. At that point, you should continue to wear a well-fitting mask around others at home and in public for five more days. Avoid places where you can’t wear a mask, such as restaurants.

Should you test again after your five-day isolation period? According to the CDC, if you have access to a home rapid (antigen) test, you can use it toward the end of your isolation period if you want to. Use it only if your symptoms are improving and you’ve been fever-free for 24 hours. If the result is positive, continue to isolate for an additional five days.

For more details on testing and isolation, visit the CDC website.

Need help getting a COVID-19 test?

Depending on where you live, you may qualify for assistance in making COVID-19 test appointments and getting to and from testing locations. You may even be able to get food delivered to your home if you’re in isolation. Some tips for getting the help you need:

• If you have trouble booking appointments online, contact the pharmacy or other testing site directly to request assistance. You might also ask a tech-savvy family member, friend, or neighbor to help you.
• Use Eldercare Locator to find transportation and other support services.
• Visit Meals on Wheels for meal delivery options in your ZIP code. Services like Instacart allow you to order groceries online from area markets and have them delivered right to your door.
• Dial "211" on your phone to be connected with support resources for older adults in your geographic area.

Vaccination is your best defense against COVID-19

Getting vaccinated continues to be one of the most important steps you can take to protect yourself, your family, and your community from COVID-19. For older adults and those with chronic health conditions, the current COVID-19 vaccines and boosters have proven to be highly effective at reducing severe illness, hospitalization, and death.

Want more information on COVID-19 and older adults? Visit our COVID-19 resource hub.

This article was updated  in May 2023 after the end of the COVID-19 Public Health Emergency and again in September 2023.