- 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.
There are two types of tests available. One type tests for an active infection or the presence of the virus. The other type tests for antibodies in the blood, which are proof that the body had a previous infection, even if symptoms never developed.
According to the latest research, this test has been shown to be both a sensitive and specific method of testing for the presence of the new coronavirus.
This test is generally performed by collecting a sample from the
- Nasopharyngeal swab. A swab is inserted into the nose and back through the nasal cavity to collect a sample from the back of the throat (pharynx).
- Oropharyngeal swab. A swab is inserted into the mouth to the back of the throat (pharynx) to collect a sample.
- Nasopharyngeal wash/aspirate. A saline wash flows into one nostril and is then sucked back out through a small tube, called a catheter, to collect a sample.
- Nasal mid-turbinate swab. A swab is inserted deep into both nostrils to collect a sample.
- Anterior nares specimen. A swab is inserted halfway into the nostrils to collect a sample.
Samples can also be collected from the lower respiratory tract. This is done by collecting fluid that may gather around the lungs (pleural fluid) and phlegm or mucus (sputum) from the lower respiratory tract.
However, upper respiratory tract sampling is easier for the healthcare provider to perform and less invasive for the patient.
In addition to the CDC’s test, Medicare covers other molecular tests for the new coronavirus as well.
As of April 28, there are
Serology antibody tests
The CDC has also created a serology
On April 11, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that all insurance providers must also cover antibody testing for the new coronavirus. Medicare covers these tests as well.
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’s 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.
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.
- 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.