COVID-19 and Medicare – What You Should Know


\According to the Centers for Disease Control and Prevention (CDC), seniors are especially susceptible to COVID-19. Although everyone is at risk of catching the virus, seniors have a greater potential for complications from COVID-19. Fortunately, Medicare has established coverage for COVID-19 tests, treatment, and other services to help you through the pandemic.

Medicare and COVID-19 testing

A swab is placed towards the back of your nasal passage to test for COVID-19. Many cities throughout the country have testing centers dedicated to this type of test. However, your doctor can perform the test as well. Medicare Part B covers the COVID-19 test at 100% if your doctor orders the test.

Because Original Medicare doesn’t charge you anything for the test, neither can Medicare Advantage plans. According to the Families First Coronavirus Response Act, cost-sharing for test-related services, such as the doctor visit or ER visit, is eliminated as well.

The COVID-19 test analyzes whether you’re currently infected or not. However, there’s another test to see if you’ve had COVID-19 in the past but aren’t now infected. This test is called the COVID-19 antibody test. 

Medicare covers the antibody test at 100% as well. The antibody test will tell you if your body has created an immune response to COVID-19. If you have, you may not be at risk of reinfection. 

Medicare and COVID-19 treatment

Medicare Part A covers services such as hospital stays, skilled nursing facility stays, at-home healthcare, and hospice care. Therefore, if you require hospitalization due to COVID-19, Medicare Part A will cover your stay. Medicare Part B covers other services such as doctor visits, diagnostic tests, and lab work. So, your doctor visits and nurse services while in the hospital would be covered under Part B. 

However, unlike the test, your stay and treatment for COVID-19 is not covered at 100%. Your ordinary Medicare cost-sharing expenses will be applied to these services if you need them. If you’re admitted to the hospital, you’ll owe your Part A deductible and any daily copays for days spent in the hospital past two months. 

If you require continued care after being released from the hospital, you may qualify for a covered stay in a skilled nursing facility. Your first 20 days are covered here if you do. Your Part B services in the hospital and skilled nursing facility would also have normal cost-sharing expenses applied, such as your Part B deductible and 20% coinsurance. 

However, if you have a Medicare Supplement plan, all or most of these expenses will be covered. Cost-sharing varies if you have a Medicare Advantage plan. Each plan sets its own copays, deductibles, and coinsurance, so your costs will likely be different. 

COVID-19 vaccine and Medicare

Currently, there is not an approved  vaccine to prevent COVID-19. Medicare Part B covers several vaccines, while Part D covers others. However, if a coronavirus vaccine  is developed, Medicare has stated that it would be a Part D vaccine, not a Part B vaccine. All Part D plans will be required to include the new COVID-19 vaccine on their formularies. 

COVID-19 and Medicare telehealth

Before the spread of COVID-19, Medicare had strict coverage guidelines for telehealth services. However, the Coronavirus Preparedness and Response Supplemental Appropriations Act has eliminated certain guidelines for the time being. Now Medicare covers telehealth doctor visits for all of its beneficiaries. 

The Part B deductible and coinsurance apply to these telehealth services, just like regular in-person visits. If you have a Medicare Supplement plan, all or most of these expenses will be covered for you.

Recommendations for Medicare beneficiaries

The majority of seniors in America have at least one pre-existing condition. Certain pre-existing conditions can make fighting off the virus more difficult. If possible, there are a few precautions you should take. 

Practice social distancing by limiting the number of outings you take. Request a 90-day day refill of your medications, and if possible, have them delivered to your home. You could also schedule a check-up with your primary care provider via telehealth to get a clean bill of health. 

Until the rapid spread of the virus is over, your day-to-day life may be altered. But the good news is Medicare has prepared for this pandemic and is ready to cover you if needed. 

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