Medicare and Medicaid Coverage for COVID-19 Testing and Treatment

Sept. 12, 2023

As of May 11th 2023, the U.S. Department of Health and Human Services (HHS) has initiated a transition out of emergency status due to the combined efforts of immunizations, testing, and social distancing. As we breathe a sigh of relief, it is important to continue to be mindful of the risk of COVID-19 and prioritize our own health and well-being as well as the health and well-being of at-risk groups such as immunocompromised individuals (have a weakened immune system), and the elderly population. People who are immunocompromised are more likely to become ill due to COVID-19 because of their medical condition or if they take certain medications that make them more susceptible to illness. However, with the help of COVID-19 vaccinations and by taking recommended precautions, we can stay healthy and protect ourselves and others from getting sick. More information about the most up-to-date COVID-19 news can be found here

As a consequence of no longer being in an emergency state, In the event of COVID-19 infection, Arizonans enrolled in Medicare Part B will continue to have coverage with no out-of-pocket costs for COVID-19-related PCR and antigen tests ordered by a doctor. This includes appropriate laboratory-based tests such as drive-through PCR and antigen testing or testing in a clinical setting. However, Medicare will no longer be covering the cost of at-home, over-the-counter COVID-19 tests. Additionally, for those enrolled in a Medicare Advantage (MA) plan, there may be more access to COVID-19 tests depending on the specific plan’s benefits. Users may check with their MA plan for testing availability and updates. Despite COVID-19 no longer being considered a public health emergency, people with Medicare coverage will continue to have access to COVID-19 vaccinations without any out-of-pocket costs.  

Arizona’s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), is a federally and state funded health care program that offers comprehensive care and preventative services to those who qualify. Health plans are broken down by county and can be assigned automatically once enrolled. Depending on your income, you may qualify for free or low-cost coverage through AHCCCS. Additionally, for Arizonans age 65 or older and meet qualifications, there are no monthly premiums. Individuals can qualify for nutrition or medical assistance through the Health-e-Arizona Plus site. 

As advised by the Arizona Department of Health Services, the best way to prevent illness and stop the spread of COVID-19 is to stay up to date on COVID-19 vaccinations and take necessary precautions. The Center for Disease Control and Prevention (CDC) recommends bivalent versions of mRNA vaccines for both the primary and booster doses of the vaccine. The bivalent vaccine includes two components; one part provides broad protection against COVID-19 and corresponds to the original virus strain and the second part provides protection against COVID-19 caused by the omicron variant. The COVID-19 vaccine helps protect against severe illness caused by COVID-19 and aids in lessening the spread of COVID-19 to other vulnerable individuals in the population, such as the elderly and immunocompromised. Eligibility for a COVID-19 vaccine depends on age, medical history, if you have received a bivalent vaccine in the past, and date of most recent COVID-19 vaccination. Information about eligibility and finding a COVID-19 vaccine can be found here

Additionally, physical distancing, wearing a face mask, isolation precautions, and personal hygiene can reduce the risk to oneself and others. Emergency warning signs for COVID-19 such as difficulty breathing, and chest pain may require immediate medical attention. More information on the signs and symptoms of COVID-19 as well as treatment options can be found on the CDC website and the Arizona Department of Health Services (AZDHS) website.

Although Medicare no longer provides no-cost, at-home, over-the-counter COVID-19 testing, the costs of these tests will be covered for those enrolled in Medicare Part B if the test is ordered by a physician in a clinical setting. In addition, Arizonans with Medicare coverage will continue to have access to COVID-19 vaccinations without any out-of-pocket costs. 

The following resources offer additional information regarding Medicare and Medicaid coverage for COVID-19 vaccination and treatment: 

  1. To get answers to frequently asked questions about COVID-19, visit the AHCCCS website here 
  2. To learn more about COVID-19 resources for the uninsured, visit the HHS Bridge Access Program for COVID-19 Vaccines and Treatments website here 
  3. To find a vaccine near you, use the AZDHS vaccine finder 
  4. To locate a COVID-19 testing center near you, click here