Medicare and COVID-19 in 2026: Tests, Vaccines, and Treatment Coverage

What changed after the COVID-19 public health emergency

Much of the no-cost COVID-19 access that Medicare beneficiaries had during the pandemic was tied to the federal public health emergency, which ended on May 11, 2023. Some benefits continued; others did not.

Two things are easy to confuse. Laboratory (PCR) tests ordered by a provider and COVID-19 vaccines are still covered at no cost under Part B. The free over-the-counter, at-home antigen tests that Medicare paid for during the emergency are not — that program ended with the emergency.

Treatments such as the oral antiviral Paxlovid also moved. During the emergency they were distributed through a federal supply at no charge; they are now covered the way any prescription drug is, through your Medicare Part D plan or a Medicare Advantage plan that includes drug coverage.

COVID-19 testing: what's covered and what isn't

There are two kinds of tests, and Medicare treats them very differently.

• Provider-ordered lab tests (PCR and similar): Covered under Part B. You usually pay nothing when a doctor or other health care provider orders the test and you get it from a Medicare-enrolled lab, pharmacy, clinic, doctor's office, or hospital.
• FDA-authorized antibody (serology) tests: Covered under Part B when ordered by a provider, generally at no cost to you.
• Over-the-counter at-home tests: No longer covered by Original Medicare. The program that gave Part B members up to eight free OTC tests per month ended with the public health emergency on May 11, 2023.
• Medicare Advantage exception: Some Medicare Advantage (Part C) plans may choose to cover OTC tests as an extra benefit. This varies by plan — check your plan's documents before assuming coverage.

COVID-19 vaccines remain free under Part B

Medicare Part B covers the updated 2025–2026 COVID-19 vaccines. You pay nothing for the shot when your doctor or other provider accepts assignment for giving it — there is no deductible or coinsurance for the vaccine itself.

Because the vaccine is a Part B benefit (not a Part D drug benefit), this applies whether you have Original Medicare or a Medicare Advantage plan. To stay at $0, get the vaccine from a provider or pharmacy that participates in Medicare and accepts assignment.

Antiviral treatment: Paxlovid and Part D

Oral antivirals such as Paxlovid (nirmatrelvir/ritonavir) are prescription drugs covered through Medicare Part D plans and Medicare Advantage plans that include drug coverage. The free federal-supply distribution that ran during and just after the public health emergency has ended, so standard Part D rules now apply.

What you pay depends on your specific plan's formulary, deductible, and cost-sharing tier — there is no single Medicare-wide copay, so it varies by plan. One protection does apply to everyone with Part D: in 2026, your out-of-pocket spending on covered Part D drugs is capped at $2,100 for the year. Once you reach that cap, you pay nothing more for covered drugs for the rest of the year.

If you think you've been exposed or have symptoms, antivirals are most effective when started early, so contact a provider promptly rather than waiting to sort out coverage details.

What you actually pay in 2026

Here is how the pieces fit together under Original Medicare. Plan specifics differ if you're in Medicare Advantage.

• Provider-ordered COVID-19 lab test: typically $0 — the Part B deductible and 20% coinsurance do not apply when the test meets coverage rules.
• 2025–2026 COVID-19 vaccine: $0 when the provider accepts assignment.
• Over-the-counter at-home tests: full retail price out of pocket under Original Medicare (some Medicare Advantage plans may differ).
• Paxlovid or other antivirals: your Part D plan's cost-sharing applies, subject to the $2,100 annual out-of-pocket cap on covered Part D drugs in 2026.
• A provider office visit related to COVID-19: standard Part B rules apply — the $283 annual deductible, then 20% coinsurance of the Medicare-approved amount.