- Original Medicare and Medicare Advantage plans both cover testing for the new coronavirus.
- Medicare Part A covers 100 percent of COVID-19 hospitalizations for up to 60 days.
- Medicare Part B covers official testing at no charge, as well as certain medications and equipment used for COVID-19 treatment.
- Medicare has also expanded its testing and telehealth coverage to include individuals in nursing homes.
In March 2020, the
You may be wondering whether your Medicare plan covers testing for the new coronavirus. The good news is that you’re covered for coronavirus testing if you’re enrolled in Medicare.
In this article, we’ll look at thecoronavirus testing and treatment options that are available to Medicare beneficiaries.
Both original Medicare and Medicare Advantage plans cover any testing for the new coronavirus performed on or after February 4, 2020, according to the Centers for Medicare & Medicaid Services (CMS).
This includes the coronavirus antibody test.
Original Medicare beneficiaries are covered for testing under Medicare Part B. The test is covered 100 percent, with no out-of-pocket costs, if it’s ordered by a doctor or another healthcare provider.
Medicare Advantage (Part C) beneficiaries are also covered for testing free of charge as part of their Medicare Part B benefits.
The coronavirus antibody test measures proteins that form in your blood when you’ve had a coronavirus infection. These proteins, also called antibodies, can show whether you’ve had COVID-19 in the past.
It may take up to 3 weeks after you’ve had an infection for antibodies to form, according to the
During an antibody test, your healthcare provider will take a blood sample, either by pricking your finger or by drawing a larger sample from a vein in your arm. The sample is sent to a lab for testing.
It may take a few days for you to get your results.
If you’re currently in a nursing home or receiving home healthcare under your Medicare Part A coverage, you’re covered for coronavirus testing free of charge under Medicare Part B.
People who have Medicare Advantage and are in a nursing home or receiving home healthcare are also covered under Medicare Part B.
On April 15, 2020, the CMS announced it would double Medicare reimbursement payments to $100 for labs that use antigen tests. The higher reimbursement rates make it easier for labs to test large groups of people when necessary.
This announcement came only 2 weeks after the CMS expanded its COVID-19 test coverage to include those who have difficulty leaving home and nonhospitalized people.
Antigen tests are designed to quickly test for the new coronavirus in large populations of individuals. They’re particularly useful in detecting SARS-CoV-2 in people who have a high viral load.
Antigen test results can be used to inform or expedite decisions on public health. Examples include measures for nursing home facilities (where early intervention may be necessary) or occupational settings.
According to an October 15, 2020, announcement from the CMS: As of January 1, 2021, the reimbursement rate of $100 will be given only to labs that can provide test results within 2 days.
Labs that need more than 2 days to provide test results will receive $75 instead.
What to do if you test positive for COVID-19
CDC recommendsthe following for anyone who has or thinks they may have COVID-19:
- Stay at home. For most people, COVID-19 symptoms are mild, and the illness can be managed at home.
- Avoid going outside. Unless you need emergency medical attention, don’t go outside to public areas or take public transportation.
- Manage your symptoms. If needed, you can use over-the-counter (OTC) medication for symptoms. Drink lots of water and get plenty of rest.
- Self-isolate. Isolate yourself to a single room, if possible. Stay away from family and pets until you’re recovered.
- Use a face mask. When you need to be around family or leave the house for any reason, wear a face mask to protect those around you.
- Seek medical attention. If at any time you have trouble breathing, seek medical attention right away.
Medicare beneficiaries also currently have access to Medicare telehealth services. If you’re isolated at home with COVID-19, telehealth offers access to your healthcare providers though your phone or other devices.
These interactive appointments can allow you to discuss your symptoms and treatment with your doctor without having to visit the facility or doctor’s office in person.
To use Medicare’s telehealth services for COVID-19, you must be enrolled in Medicare Part B or a Medicare Advantage plan.
Medicare telehealth services can be accessed from:
- your home
- a hospital
- a nursing home
- a doctor’s office (you and your doctor will be placed in separate locations within the office)
Keep in mind that you’re still responsible for paying your Medicare Part B costs, such as deductibles and copays, for these services.
If you’re enrolled in Medicare, your care for the new coronavirus or COVID-19 is covered. It includes:
- doctor’s appointments
- telehealth appointments
- prescriptions for medication used to treat COVID-19
- hospitalizations for care related to COVID-19
If you have COVID-19, the parts of Medicare will each cover a portion of your care:
- Medicare Part A. Medicare Part A covers hospitalization, nursing facility care, and hospice care. If you’re admitted to any of these facilities for care for COVID-19, these services will be paid by Part A. Any medications you receive while you’re in these facilities will also be covered by Part A.
- Medicare Part B. Medicare Part B covers outpatient care such as doctor’s appointments, telecare, and coronavirus testing. Medications that are physician-administered or infusion drugs are covered by Part B as well. Part B also covers any available vaccines.
- Medicare Part C (Advantage). Medicare Advantage combines the services of original Medicare. If you have Medicare Advantage, it’ll cover the same services as parts A and B. If you have prescription coverage included, your medications will be covered as well.
- Medicare Part D. Medicare Part D is prescription drug coverage and is available to all Medicare recipients who purchase it. Any outpatient medications used to treat COVID-19 will be covered by Part D.
- Medigap (supplemental insurance). Medigap helps cover out-of-pocket costs not included in original Medicare. If you have a Medigap policy, out-of-pocket costs associated with your COVID-19 treatment and care may be covered.
Remdesevir is the only medication that’s been approved by the Food and Drug Administration (FDA) to treat people with COVID-19. It’s an intravenous (IV) infusion medication that’s given to people who are hospitalized.
The FDA has issued emergency-use authorizations (EUAs) for other medications. EUAs allow products without FDA approval to be used when there are no suitable, FDA-approved alternatives.
Medications that have received EUAs include:
- casirivimab and imdevimab, which must be administered together
Like remdesevir, these particular medications are also administered by IV infusion. However, they’re given as outpatient therapy and are intended for people with mild to moderate illness and a high risk of disease progression.
The goal of bamlanivimab and casirivimab-imdevimab is to help prevent hospitalization. These medications must be administered by a healthcare provider in a setting such as an outpatient hospital facility or infusion center. Healthcare providers should also monitor people immediately after they’re given these medications.
Any COVID-19 medications that have received FDA approval or an EUA are covered by Medicare.
Mild cases can generally be treated at home with lots of rest and hydration. However, in some cases, COVID-19 can become serious and may require hospitalization.
Hospitalization related to COVID-19 is covered under Medicare Part A.
Other than your Part A deductible, you’re covered for 100 percent of your inpatient hospital costs for the first 60 days. After that, you’ll owe a coinsurance amount of $371 or higher, depending on the length of your stay.
If you’ve been hospitalized for COVID-19, you may require treatments such as:
- intravenous (IV) fluids
- oxygen therapy
- fever-reducing medications
- antiviral medications
- respiratory therapy, such as a ventilator
Any medications that you require during hospitalization, such as remdesevir, are covered under Medicare Part A. Any equipment that you might need, such as a ventilator, is covered under Medicare Part B and is considered durable medical equipment.
In response to the coronavirus pandemic, Medicare has introduced measures to help protect you and ensure additional healthcare is available. These include:
- relaxing rules that require Medicare Advantage plans and prescription drug plans to get prior authorization for necessary drugs
- allowing healthcare facilities that aren’t normally covered by Medicare to provide care for Medicare recipients with COVID-19
- making it easier for people with COVID-19 to receive care at skilled nursing facilities
- providing more information to nursing homes and other healthcare facilities to help answer questions they may have regarding coronavirus and COVID-19
- creating new codes to help make it easier to bill Medicare for services provided related to coronavirus and COVID-19
- mobilizing a national network of organizations to focus on infection control and prevention, abuse, and neglect in nursing homes and hospitals
- Medicare beneficiaries are covered for testing of the new coronavirus under all original Medicare and Medicare Advantage plans through Medicare Part B.
- Medicare has also expanded its testing coverage to include more beneficiaries in nursing homes.
- Medicare is offering telehealth appointments for anyone seeking at-home treatment for COVID-19.
- If you’re hospitalized for COVID-19, your treatments are covered under both Medicare Part A and Medicare Part B.