Do medicare plans cover Coronavirus? The brief answer is YES.  Medicare plans do cover coronavirus (COVID-19) tests and treatment.  Covid-19 lab tests and the costs of hospitalization are covered by Medicare Part A and Medicare Part B. Lab tests are ‘free’.  There will be zero out of pocket expenses, co-pays or co-insurance, for the test itself or relevant office visits.  Treatment is a separate issue and will generally be subject to the terms of your personal plan health insurance.

If there are dependent children (below age 16) in the household they will be covered by CHIP and, subject to your State legislation, eligible for free testing and treatment.

Citizens on Medicaid should check with their local benefits office.  States must meet the conditions described above but many are more generous.

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If you have the three symptoms of COVID-19

  • New (dry) continuous cough
  • High temperature
  • Breathing difficulty

you should call your provider (virtual check-in, SEE SECTION, TELEHEALTH below). DO NOT visit without an appointment.  DO NOT travel by public transport.

If you have a MEDICARE ADVANTAGE PLAN you have access to COVID-19 lab tests and medically necessary hospitalizations, but you should check with your plan provider about coverage and costs.

TO SUMMARIZE

Medicare coverage includes: –

  • Tests for COVID-19: You pay no out-of-pocket costs.  The coverage applies both to the test itself and to the visit in which the test was administered
  • Medically necessary hospitalizations. This includes hospital stays which are extended because you have been diagnosed with COVID-19 and might otherwise have been discharged from the hospital following a prior inpatient stay.

Medicare Advantage plans offer the same benefits but you should check the terms of your plan with your insurers.  Advantage plans may offer additional telehealth benefits beyond the ones described above.  Check with your plan about your coverage and costs.

Advantage plans are permitted to waive cost-sharing for COVID-19 lab tests. 

The Families First Coronavirus Response Act passed through the House and Senate on March 18th.  The act extends coronavirus coverage for free testing to Medicaid beneficiaries and group health insurance plans.

Estimates suggest (The American Action Forum) that the federal government is committing approximately $1.3 billion in federal healthcare spending for testing and around $56.3 billion for other Medicaid costs. 

This gives a clear indication of the value of your Medicare card to you AND to would-be fraudsters. The COVID-19 scare will only heighten the threat of opportunistic or planned misuse.  You should treat it with same respect and level of security as your credit cards.

Telehealth & related services [drawn from Medicare.gov, Medicare and Coronavirus]:

In response to the unprecedented demand for medical services, Medicare has temporarily expanded its coverage of telehealth services.  “These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). During this time, you will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings. This will help ensure you are able to visit with your doctor from your home, without having to go to a doctor’s office or hospital, which puts you and others at risk of exposure to COVID-19”.

FINALLY, we remind you that a test for COVID-19 infection which gives a negative result does NOT MEAN that you are immune from the disease nor does it convey any immunity.  

You must continue to observe the SOCIAL DISTANCING (see our article on Social Distancing, Quarantine and Islocation) regulations, maintain high standards of personal and environmental HYGIENE, and the levels of ISOLATION appropriate to your household.

Read our article on COVID-19 by taking care of yourself you are taking care of all of us?