What Does Medicare Cover for COVID-19 Care?

MEDICARE COVERS THE COVID-19 VACCINE

If you are currently enrolled in Medicare, you can receive the COVID-19 vaccine at no additional cost to you. The Centers for Disease Control (CDC) has identified older adults and people who have severe chronic medical conditions as groups that are at higher risk for COVID-19, which means most people with Medicare are at higher risk and able to receive the COVID-19 vaccine.

Check with your local health department on the status of COVID-19 vaccines in your area, and be sure to bring your Medicare card so that your doctor, hospital or other health care provider can bill Medicare for your vaccine.

 

MEDICARE COVERS COVID-19 LAB TESTS

You pay no out-of-pocket costs for COVID-19 detection tests when you are enrolled in Original Medicare. The test must be from a laboratory, pharmacy, doctor or hospital. In some cases, a home health nurse or otherwise appropriately-trained medical assistant may collect your test specimen for you in your home.

Medicare covers these tests at different locations, including some drive-up test sites such as “parking lot” testing locations, and Medicare Advantage Plans cannot charge you a copayment, deductible or coinsurance for COVID-19 detection tests.

 

MEDICARE COVERS COVID-19 ANTIBODY TESTS & TREATMENT

Medicare also covers FDA-approved Coronavirus antibody, or “serology”, tests. These tests are to see if you have developed an immune response to COVID-19 and may not be as high of a risk for infection or reinfection.

If you have tested positive for COVID-19 and have a high risk of progressing past a mild or moderate state, Medicare Part B will also cover COVID-19 monoclonal antibody treatment. You pay nothing for this treatment when you receive it from a Medicare provider or supplier.

 

MEDICARE COVERS MEDICALLY NECESSARY HOSPITAL STAYS

If you require hospitalization due to Coronavirus, Medicare Part A helps to cover your inpatient hospital care. The hospitalization must be from an official doctor’s order, and the hospital must accept Medicare. You may still have to pay for applicable deductibles, coinsurance and/or copays, but you will receive Medicare-covered services such as meals, general nursing, semi-private rooms and other services that are needed as part of your Coronavirus inpatient treatment.

 

HOW DO I KNOW WHAT MEDICARE WILL COVER FOR ME?

The U.S. Centers for Medicare & Medicaid Services (CMS) has confirmed that Medicare will cover the COVID-19 vaccine, COVID-19 lab tests and medically necessary inpatient care due to Coronavirus-positive illness. Be sure to review your individual Medicare plan(s) to confirm benefit details and available doctors and health networks in your area for testing and treatment, and stay up-to-date on local availability and requirements for COVID testing, treatment and availability.

If you are unsure about your Medicare coverage, or would like help confirming available benefits and Medicare networks in your area, consult with a trusted local Medicare specialist today.