COVID-19, also known as the coronavirus, has significantly impacted the year 2020, and not in a good way. COVID-19 is a respiratory disease that is highly transmissible. The disease has caused over 300,000 deaths in the United States in 2020, and eight out of ten of those deaths are seniors aged 65 and older.[1]
Senior citizens and others with underlying health conditions are at higher risk for severe COVID-19 symptoms. Therefore, seniors need health insurance that will provide coverage for COVID-19 treatment. The federal health insurance program for seniors aged 65 and older and others with specific disabilities is Medicare. So that leaves this question, will Medicare cover COVID-19 treatment?
Medicare coverage for COVID-19 testing
There are two different coronavirus tests that detect the coronavirus: the nasal swab and antibody test. The COVID-19 nasal swab detects if you currently have the virus, while the antibody test shows you have the virus’s antibodies; therefore, you have had the virus in the past.
If you are administered either of these tests at a hospital, doctor’s office, laboratory, or drive-thru location that accepts Medicare, then Medicare Part B will cover the COVID-19 test. Typically, when you receive outpatient services, you pay the Part B deductible ($203 in 2021) or coinsurance. However, Medicare covers both COVID-19 tests at 100%. You will not have any out-of-pocket costs for a COVID-19 test.
This also applies to beneficiaries with a Medigap or Medicare Advantage plan. All copayment and deductible amounts for a COVID-19 test are waived if the doctor/facility accepts your Medicare plan.
Medicare coverage for COVID-19 hospitalizations
If you were to become severely ill from the COVID-19 virus, you might need to visit the hospital to ensure you are not vulnerable to severe COVID-19 complications. Your doctor may require you to become an inpatient at the hospital to receive the extensive care you need. When you become an inpatient at the hospital, Medicare Part A would pay for your COVID-19 treatment.
As an inpatient, Medicare Part A covers your room, meals, lab services, and medications. There are cost-sharing expenses you will be responsible for as an inpatient. For example, you must pay the Part A deductible, which is $1,484 in 2021, before Medicare covers your inpatient care. Medicare covers your stay fully up to 60 days as an inpatient. If your inpatient stay were to exceed 60 days, you would pay a copay of $352 for days 61 through 90.
Once discharged from the hospital, your doctor may recommend staying at a skilled nursing facility to help you recover. Medicare Part A covers a 20 day stay at a skilled nursing facility at no cost to you as long as you were an inpatient for at least three days. If you must stay at the facility for more than 20 days, you will pay a daily copay of $185.50 up until day 100.
Medicare coverage for COVID-19 vaccination
The U.S. Food and Drug Administration (FDA) has recently approved the emergency use of the Pfizer and Moderna COVID-19 vaccination for United States citizens. These vaccines are currently being distributed, and many Americans who are at higher risk of the virus have already received the vaccination. Both of these vaccinations require two separate injections weeks apart in order to be effective.
The CARES Act passed in March 2020 states that Medicare Part B will cover a COVID-19 vaccine at no cost to the beneficiary. If you receive a COVID-19 vaccination, Medicare will cover the cost of the vaccination and the cost to administer it. Therefore, you will not have any out-of-pocket costs for a coronavirus vaccine.
According to the FDA, there can be side effects of the vaccine, but they typically only last a couple of days. A few of the vaccine’s side effects are tiredness, headaches, pain where you were injected, chills, joint pain, fever, and vomiting. On that note, these side effects typically do not appear until the second vaccination is received.
Summary
Medicare does cover COVID-19 treatment and will continue to cover its beneficiaries throughout these unprecedented times. If you want to learn more about Medicare coverage for COVID-19 treatment, visit Medicare.gov or CMS.gov for more information.
