What Will Medicare Cover During the COVID-19 Pandemic?
The COVID-19 pandemic is still ongoing throughout the world and there is still uncertainty surrounding this virus. A common question among Medicare recipients is what will Medicare cover? Is there a charge for testing or for a vaccine that is developed? What happens if I need hospital care for COVID-19? This article answers these important questions and explains how Medicare supports recipients during this time.
Testing for COVID-19
COVID-19 testing is an important tool for helping diagnose people and manage the pandemic. Original Medicare does not charge for COVID-19 testing when it is administered by a doctor, lab, pharmacy, or a hospital. Location testing sites such as those in parking lots and at home testing is also covered by Medicare. Additional tests covered in full by Medicare are the COVID-19 antibody test and some respiratory testing completed in conjunction with the COVID-19 test.
Medicare Advantage enrollees have coverage when it comes to testing as well. No co-pays, coinsurance, or deductibles will be charged for lab testing to diagnose or detect COVID-19.
Will Medicare Cover the Cost of a Vaccine When Available?
Yes. Under Medicare Part B, vaccines for preventable diseases like the flu are covered. Since a COVID-19 vaccine may fall under a medically necessary vaccine, it will be covered.
What Does Medicare Cover During a COVID-19 Hospital Stay?
Medicare Part A is the part that covers hospital stays. It covers aspects of the hospital stay such as meals, general nursing staff, semi-private rooms, and supplies. There is a deductible that must be paid under original Medicare. The current deductible is $1408. Once this is paid, no coinsurance payment is due for the first 60 days of a hospital stay.
Once 60 days have gone by, the Medicare beneficiary pays a $352 insurance charge for days 61-90 of a hospital stay. Lifetime reserve days are used after 90 days and the beneficiary must pay the coinsurance amount for these. After the lifetime reserve days are exhausted, the beneficiary must pay all costs associated with the stay. Beneficiaries are given a total of 60 lifetime reserve days over their lifetime.
Medicare Advantage plan holders will not be charged more during COVID-19. The plans must pay for any services rendered under Medicare Parts A and B. They must also pay for routine services like vision and dental. Requirements for prior-authorization are also waived right now for services related to COVID-19.
Inpatient Quarantine and Medicare
Medicare does provide coverage for in-patient quarantine. If a recipient is required to stay in an inpatient quarantine after being treated and before going home, Medicare will cover this stay. Hospitals are not allowed to charge for a private room if they have semiprivate rooms and a private room is necessary. If a beneficiary has been discharged for everything but quarantine, paying a deductible is not required.
Ambulatory Services
Deductibles and co-insurance payments will apply to doctor’s visits, hospital outpatient services, home health, and durable medical equipment. The only exception is if a beneficiary is quarantined in an ambulatory care place Medicare would pay for medically necessary services. Remote visits are also covered under Medicare Part B. Medicare Advantage beneficiaries are also covered for necessary services via telehealth.
Extended Prescription Refills
Local Medicare contractors will consider if some requires a supply of more than 30 days. They will factor in things like illness and the likelihood of the supply chain being disrupted. People who have Medicare Part D coverage must have also adequate access to medications.
Ambulance Service
Medicare will also cover medically necessary ambulance transport. Planes and helicopters transporting patients for rapid transport reasons may also be covered.
COVID-19 has left most people feeling uncertain because the virus is still being studied. But during times of illness or if a test or vaccine is available, Medicare will cover it.
If you’re not sure how to understand what Medicare covers during this pandemic, talk with the staff at MedicareWise. They’ll help you better understand what types of services Medicare will pay for.
