How Does Medicare Cover Costs Related to COVID-19?

More than 60 million people are enrolled in Medicare, which offers coverage for people age 65 or older and American citizens under age 65 with qualifying disabilities and diseases. This is the same group of people that are hardest hit by the coronavirus pandemic. The CDC estimates that people age 65 or older account for 8 out of 10 COVID-19 deaths. If you are a Medicare beneficiary, you might be wondering what medical costs related to COVID-19 are covered by the Medicare programs. In this article, we will take a look at what Medicare covers.

Coronavirus Testing

Medicare Part B offers coverage for COVID-19 testing, and you will pay nothing for the test. Medicare Part B also provides coverage for the costs of other tests needed to confirm a COVID-19 diagnosis; an example is the CT scan of your lungs. However, you are typically required to pay 20 percent of the entire cost after meeting your Medicare Part B deductible. If you have a Medicare Advantage plan, you’ll also be covered for the coronavirus testing.

Vaccine

Medicare Part B offers coverage for Food and Drug Administration (FDA)-approved COVID-19 vaccines. Medicare beneficiaries will pay nothing for the vaccine. And you will not be responsible for a deductible, copayment, or coinsurance. Those that have Medicare Advantage plans will also have access to the COVID-19 vaccine.

Inpatient Hospital Care

While Medicare Part A provides coverage for a semi-private room, it can also pay for a private room if it is medically necessary. For instance, if you need a private room to be quarantined, Medicare won’t need you to pay an additional cost for the room. As for the people with a Medicare Advantage plan, they will need to contact their plan to learn about the coverage rules and sharing for inpatient hospital stays.

Skilled Nursing Facility Care

Medicare Part A typically pays for SNF care if you are an inpatient for three days in a row before entering a skilled nursing facility. During this pandemic, the 3-day qualifying hospital stay has been removed for Medicare members who are affected by the coronavirus public health emergency. For instance, Medicare Part A may offer coverage for your SNF care and waive the 3-day stay if you were transferred to make room at a local hospital or due to nursing home evacuation.

Prescription Drug Coverage

Medicare provides certain prescription drug coverage for Medicare beneficiaries. As a Medicare member, Medicare also offers coverage for existing COVID-19 drug treatments that may occur. For instance, the FDA has approved remdesivir (Veklury) for those with COVID-19.

Telehealth Services

This is a full visit with a health care provider using video or a phone that allows for both video and audio communication. Medicare generally only offers telehealth coverage in limited situations, but they have expanded the coverage and access during the health emergency. Medicare covers your doctor’s visits, preventative health screenings, behavior counseling, and other essential visits through telehealth in settings, including your house.

To find out more about costs and coverage for COVID-19 care, contact Medicare Sharks for specific information.

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