What people on Medicare can expect once the Covid-19 public health emergency ends

WASHINGTON — People with Medicare will pay more for some Covid-19 tests and treatments after the public health emergency ends, according to the agency that oversees the program.

The Biden administration will end the federal Covid-19 public health emergency declaration on May 11, bringing an end to some of the free services that lawmakers had guaranteed patients in various Covid-19 relief laws.

Seniors will no longer get free over-the-counter Covid-19 tests, and they will eventually have to pay for Covid-19 treatments like Pfizer’s Paxlovid antiviral. At least at first, however, the antivirals will continue to be free because current doses in circulation were provided by the U.S. government. When the products transition to the commercial market in the summer or early fall, there may be some cost-sharing, the agency said.

Some products and services will still be free, however. Medicare covers recommended vaccines for free, and lab tests and antigen tests ordered by a physician or other health care provider will still be free, a CMS spokesperson said.

Right now there are no authorized monoclonal antibody treatments that are effective against currently circulating Covid-19 variants, but if new ones are authorized, they will still be covered for free for patients through the end of December, the spokesperson said.

The future costs for patients who get insurance through their employers are less certain, however.

STAT reached out to the insurance lobbying group AHIP and UnitedHealth Group, Kaiser Permanente, Aetna, HCSC, Cigna, Centene, Elevance, and Humana, and none of them had any information to offer to patients about what they can expect to pay for Covid-19 tests and treatments.

Patients with private insurance could have to pay for either over-the-counter Covid-19 tests, or those conducted in doctors’ offices. Payment for Covid-19 treatments could move on a similar trajectory to Medicare, as the medicines are offered in the normal commercial channel instead of being purchased by the government. Insurers usually cover vaccines without cost-sharing as preventative services.

The Medicaid program will also see several changes — while vaccines will still be covered for free, cost protections on Covid-19 testing and treatment services will end in 2024. A Medicaid pathway that allowed states to cover testing, vaccinations, and treatments for uninsured patients using federal funds will end in May.