How is COVID-19 diagnostic testing covered?
The following lab testing coverage is effective from Feb. 4, 2020 through the public health emergency which is set to expire on May 11, 2023:
Medica Medicare Supplement (Signature Solution) will cover the cost of medically necessary PCR COVID-19 diagnostic testing (COVID-19 infection). Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets Centers for Disease Control and the Food and Drug Administration (FDA) guidelines, and is ordered by an appropriate medical professional.*
Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. That means the member's share of the cost will be waived for office visits, urgent care, walk-in retail health clinics, emergency room, and outpatient facilities when the member is being tested for COVID-19.
What is the difference between PCR and antigen COVID-19 diagnostic tests?
A PCR (or Polymerase Chain Reaction) test is used to detect genetic material from a specific organism, such as a virus. PCR tests detect viral RNA. PCR tests are sent to a lab for the assessment of the test. Results generally take a couple of days.
Antigen tests, also called rapid diagnostic tests, detect specific proteins on the surface of the coronavirus. Antigen tests can be purchased through a retailer and done at home. Results may come back in as little as 15 to 45 minutes.