Place Your Order For Your Free COVID-19 Test Kits

Make sure you have your Medicare card ready. Enter your information as shown on your Medicare card and the address you want your tests sent to.

Once your eligibility is approved, you should receive your tests within 3-7 working days.

** If you have insurance provided by an employer, you do not qualify for this program.

First Name*

Last Name*

Street Address*

City/Town*

ZIP Code*

Phone*

Email*

Date of Birth*

Sex

Male Female

Medicare ID (XXXX-XXX-XXXX)

By submitting I give EXPRESS WRITTEN CONSENT authorizing InspirationHATC to be my preferred provider for my 8 At Home FDA Authorized, Covid-19 Tests each month for the duration of the Public Health Emergency (PHE). These tests are provided at no cost to me and are 100% covered by Medicare. Both boxes below must be checked in order for InspirationHATC to process your order.

I am not currently confined to a skilled nursing facility I accept and understand I will receive notice each month to continue receiving my no cost COVID-19 Tests provided by Medicare

Please do not fill this field!