- As of February 4, 2020, Medicare covers 2019 novel coronavirus testing free of charge for all beneficiaries.
- Medicare Part A covers you for up to 60 days if you’re admitted to the hospital for the treatment of COVID-19, the illness caused by the 2019 novel coronavirus.
- Medicare Part B covers you if you require doctor’s visits, telehealth services, and certain treatments for COVID-19, such as ventilators.
- Medicare Part D covers future 2019 novel coronavirus vaccines, as well as any drug treatment options that are developed for COVID-19.
- There may be some costs related to your care associated with COVID-19 and the 2019 novel coronavirus, depending on your plan and your deductible, copayment, and coinsurance amounts.
The World Health Organization (WHO) recently declared the disease (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2)
This outbreak is the newest illness caused by different strains of coronaviruses.
Whether you’re enrolled in original Medicare or Medicare Advantage, you can rest assured that you’re covered for testing for the 2019 novel coronavirus and diagnosis and treatment for COVID-19.
In this article, we’ll explore everything you need to know about what Medicare covers for the 2019 novel coronavirus and the illness it causes.
Recently, Medicare provided beneficiaries with information on how the agency is contributing during the COVID-19 pandemic. Here’s what Medicare will cover if you‘re a beneficiary:
- 2019 novel coronavirus testing. If you’ve been experiencing the symptoms of COVID-19, you should be tested. Medicare covers the necessary testing for the 2019 novel coronavirus completely free of charge.
- COVID-19 treatment. Many people who contract the 2019 coronavirus may have no symptoms. If you develop illness from the virus, you may be able to ease your symptoms at home with over-the-counter medications. As further COVID-19 treatment options become available, medications will likely be covered under your prescription drug plan.
- COVID-19 hospitalizations. If you’re hospitalized because of illness due to the 2019 novel coronavirus, Medicare will cover your inpatient stay for up to 60 days.
Almost all Medicare beneficiaries fall into the at-risk population for serious COVID-19 illness: individuals ages 65 and older and those with chronic health conditions.
Because of this, Medicare is playing an important role in ensuring that the most vulnerable are taken care of during this pandemic.
Medicare will continue to adjust its coverage as needed for beneficiaries who have been affected by the novel coronavirus.
2019 CORONAVIRUS: understanding the terms
- The 2019 novel coronavirus is called SARS-CoV-2, which stands for severe acute respiratory syndrome coronavirus 2.
- SARS-CoV-2 causes an illness called COVID-19, which stands for coronavirus disease 19.
- You may be tested to see if you have contracted the virus, SARS-CoV-2.
- You may develop the disease, COVID-19, if you have contracted SARS-CoV-2.
If you’re enrolled in Medicare, you’re covered for 2019 novel coronavirus testing with no out-of-pocket costs. This coverage applies to all 2019 novel coronavirus tests performed on or after February 4, 2020.
Medicare Part B is the part of Medicare that covers 2019 novel coronavirus testing. Here’s how the coverage works:
- If you’re enrolled in original Medicare, you’re already enrolled in Medicare Part B. You will be covered for the test.
- If you’re enrolled in Medicare Advantage, you’re already covered for all services under Medicare Part B.
- If you have a Medigap plan with your original Medicare, it will not come into play since all Medicare beneficiaries will be covered for 2019 novel coronavirus testing at no cost.
As a Medicare beneficiary, you’re also covered for doctor’s visits if you have COVID-19. Unlike the requirement for testing, there’s no “time limit” for this coverage.
In addition to covering laboratory testing, Medicare Part B also covers the diagnosis and prevention of medical conditions, which includes doctor’s visits.
Costs for these visits can vary depending on the type of plan you have. Here’s how that coverage works:
- If you’re enrolled in original Medicare, you’re already enrolled in Medicare Part B and are covered for doctor’s visits.
- If you’re enrolled in Medicare Advantage, you are covered for Medicare Part B and any necessary doctor’s visits.
- If you have a Medigap plan with your original Medicare, it may help cover your Medicare Part B deductible and coinsurance costs.
Keep in mind that people who are experiencing only mild COVID-19 symptoms are advised to stay at home. However, if you still want to speak with a doctor, you can take advantage of your Medicare telehealth options.
Does Medicare cover telecare for COVID-19
Telemedicine is used by health professionals to offer medical care to individuals via interactive telecommunication systems.
As of March 6, 2020, Medicare covers telehealth coronavirus services for Medicare beneficiaries with the following criteria:
- You’re enrolled in Medicare Part B through original Medicare or Medicare Advantage.
- You’re seeking treatment and other medical advice for COVID-19.
- You’re in an office, assisted living facility, a hospital, nursing home, or at home.
If you choose to use Medicare’s telehealth services for COVID-19 diagnosis and treatment, you’ll still be responsible for your Part B deductible and coinsurance costs.
If you have Medigap, some plans may help cover these costs.
Medicare beneficiaries who may be affected by COVID-19 can choose to seek either in-person or telehealth services for testing, diagnosis, and treatment.
If you’re older and are experiencing more
If you think you may have COVID-19 and need to go to an emergency room, call ahead if possible to let them know that you may have COVID-19 and are on your way.
If you’re experiencing mild symptoms of COVID-19, Medicare’s telehealth services might be a better option for you.
This would allow you to receive medical advice without the risk of transmitting the virus to others and from the comfort of your home.
Contact your doctor or healthcare provider for more information about the telehealth services they may offer.
All Medicare beneficiaries are required to have some sort of prescription drug coverage, so as a beneficiary, you should already be covered for COVID-19 drug treatments as they develop.
Medicare Part D is the part of original Medicare that covers prescription drugs. Almost all Medicare Advantage plans also cover prescription drugs, as well. Here’s how the Medicare drug coverage works:
- If you’re enrolled in original Medicare, you must be enrolled in Medicare Part D as well for prescription drug coverage. Medicare Part D plans will cover prescription drugs necessary in the treatment of COVID-19, including COVID-19 vaccines that are developed.
- If you’re enrolled in Medicare Advantage, your plan likely covers prescription drugs and future vaccines for COVID-19. Contact your plan provider to be sure about exactly what is covered.
- If you have a Medigap plan that was purchased after January 1, 2006, that plan does not cover prescription drugs. You need to have a Medicare Part D plan to ensure you have help paying for your prescription drugs, since you cannot have both Medicare Advantage and Medigap.
There are currently no treatments that have been approved for COVID-19; however, scientists worldwide are working every day to develop drugs and vaccines for this illness.
For mild cases of novel coronavirus, it’s recommended that you remain at home and rest. Some milder symptoms, such as fever, can also be treated with over-the-counter medications.
More serious confirmed cases of novel coronavirus may require hospitalization for treatment of the symptoms, especially if they include:
- a high fever
- trouble breathing
If you’ve been admitted to the hospital for the 2019 novel coronavirus, Medicare Part A will cover hospitalization costs. Here’s how the coverage works:
- If you’re enrolled in original Medicare, Medicare Part A covers you 100 percent for inpatient hospital stays of up to 60 days. You will still need to pay your Part A deductible before Medicare pays out, though.
- If you’re enrolled in Medicare Advantage, you’re already covered for all services under Medicare Part A.
- If you have a Medigap plan with your original Medicare, it will help pay for the Part A coinsurance and hospital costs for an additional 365 days after Medicare Part A stops paying. Some Medigap plans also pay a portion (or all) of the Part A deductible.
A ventilator may be necessary for hospitalized patients with COVID-19 who cannot breathe on their own.
This treatment, which the Centers for Medicare & Medicaid Services (CMS) defines as durable medical equipment (DME), is covered under Medicare Part B.
Both Medicare Part B and Medicare Part D cover vaccines when they’re necessary to prevent illness.
As a part of Medicare.gov’s 2019 novel coronavirus policy, when a COVID-19 vaccine is developed, it will be covered under all Medicare Prescription Drug plans. Here’s how the coverage works:
- If you’re enrolled in original Medicare, you’re required to have a Medicare Part D plan. This will cover you for any future COVID-19 vaccine that’s developed.
- If you’re enrolled in Medicare Advantage, your plan likely already covers prescription drugs. This means that you’re also covered for a COVID-19 vaccine, when one is released.
Medicare consists of Part A, Part B, Part C, Part D, and Medigap. No matter what kind of Medicare coverage you have, new Medicare policy has made sure that you’re as covered as much as possible for COVID-19 care.
Medicare Part A
Medicare Part A, or hospital insurance, covers hospital-related services, home health and nursing facility care, and hospice services. If you’re admitted to the hospital for COVID-19, you’re covered by Part A.
Medicare Part B
Medicare Part B, or medical insurance, covers the prevention, diagnosis, and treatment of health conditions. If you require diagnostic doctor’s visits, telehealth services, or COVID-19 testing, you’re covered by Part B.
Medicare Part C
Medicare Part C, also called Medicare Advantage, covers both Medicare Part A and Part B services. Most Medicare Advantage plans also cover:
- prescription drugs
- other healthcare perks
Any novel coronavirus services that are covered under Part A and Part B are also covered under Medicare Advantage.
Medicare Part D
Medicare Part D, or prescription drug coverage, helps cover your prescription drugs. This plan is an add-on to original Medicare. Any future vaccines or drug treatments for COVID-19 will be covered by Part D.
Medigap, or supplemental insurance, helps cover the costs associated with Medicare Part A and Part B. This plan is an add-on to original Medicare.
If you have costs associated with your COVID-19 care, those may be covered by Medigap.
Medicare offers a wide variety of COVID-19 coverage for Medicare beneficiaries. Under Medicare, you’re covered for the testing, diagnosis, and treatment of COVID-19.
While the 2019 novel coronavirus test is completely free for all Medicare beneficiaries, there may still be some out-of-pocket costs associated with your diagnostic and treatment services.
To find out your exact coverage and costs for COVID-19 care, contact your Medicare plan for specific information.
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