- Original Medicare and Medicare Advantage plans both cover testing of the new coronavirus.
- Medicare Part B covers official testing at no charge, as well as certain medications and equipment used for COVID-19 treatment.
- Medicare Part A covers 100 percent of COVID-19 hospitalizations for up to 60 days.
- Medicare has also recently expanded its testing and telehealth coverage to include individuals in nursing homes.
With the recent outbreak and increase in testing, you may be wondering whether your Medicare plan covers testing for this virus. The good news is that if you’re enrolled in Medicare, you’re covered for coronavirus testing.
In this article, we’ll look at the coronavirus testing and treatment options that are available to Medicare beneficiaries.
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 other healthcare provider.
Medicare Advantage beneficiaries are also covered for testing free of charge under their Medicare Part B coverage.
The coronavirus antibody test measures proteins that form in your blood when you have had an infection. These proteins are called antibodies and can show if you have had COVID-19 in the past. It may take up to three weeks after you’ve had an infection for antibodies to form.
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.
On April 15, 2020, the CMS announced it would double Medicare reimbursement payments for the use of rapid tests.
The purpose of rapid testing is to diagnose COVID-19 in larger populations of individuals, such as those in nursing homes. 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 patients.
What to do if you test positive for COVID-19
CDCrecommends the following for anyone who has, or think 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 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
- other doctor’s office
Keep in mind that you’re still responsible for paying your Medicare Part B costs for these services, such as deductibles and copays.
If you are enrolled in Medicare, your care for coronavirus or COVID-19 is covered Including:
- doctor visits
- telehealth appointments
- prescriptions for medication used to treat COVID
- hospitalizations for care related to COVID
The parts of Medicare will each cover a portion of your care if you have COVID-19.
- Original Medicare (parts A and B). Medicare Part A covers hospitalization, nursing facility care, and hospice. If you are admitted to any of these facilities for care for COVID-19, these services will be paid by Part A. Medicare Part B covers outpatient care like doctor appointments, telecare, and coronavirus testing.
- Medicare Part C (Advantage). Medicare Advantage combines the services of original Medicare. If you have Medicare Advantage, it will cover the same services as original Medicare, and 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 medications used to treat COVID will be covered by Part D as will any future vaccines.
- 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.
There are currently no approved drugs or vaccines for the treatment of COVID-19. 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 $352 or higher depending on the length of your stay.
If you’ve been hospitalized for COVID-19, you may require treatments such as:
- IV fluids
- oxygen therapy
- fever-reducing medications
- antiviral medications
- respiratory therapy, such as a ventilator
Any medications that you require during hospitalization are covered under Medicare Part A. Any equipment that you might need, such as a ventilator, is covered under Medicare Part B as durable medical equipment.
In response to the coronavirus pandemic, Medicare has introduced additional measures to help protect you and ensure additional healthcare is available. These include:
- relaxing rules that require for 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 and 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 recently 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, you’re covered under both Medicare Part A and Medicare Part B for treatments you need.