As coronavirus has spread across the globe affecting millions of people, there is still a great deal of uncertainty regarding the disease. One of the common questions posed by many is: “If I end up with complications from coronavirus and end up in the hospital, will Medicare help pay my bills?” Having an illness is stressful enough, but having to worry out the financial impact of your medical needs can be devastating. Understanding your Medicare coverage can help.
Does Medicare Cover Coronavirus Treatment and How Much Will It Cost?
Most people who contract COVID-19, will have mild cases. In severe cases, you may require emergency medical treatment. If you initially go to the emergency department, your visit will be covered by Medicare Part B, which will also cover ambulance rides or physician visits.
However, if your treatment requires admission to the hospital, your treatment will be covered under Medicare Part A. For most people, there are no premium payments for Medicare Part A. In 2020, Part A carries a deductible of $1,408 for each benefit period.
In addition to these deductible costs, there are also copayment costs associated with hospital stays that are longer than 61 days. For each day between day 61 and 90 of your stay, there is a $352 daily copayment. For lifetime reserve days, there is a $704 daily copayment. However, a lengthy stay is unlikely given the standard disease process associated with COVID-19. To help with these fees, many people use supplemental coverage, like Medigap. Medigap, or Medicare Supplement, plans can pay a portion or the entirety of your out-of-pocket costs.
For those with Medicare Advantage plans, the cost of care is slightly different. Due to the current state of the pandemic, Medicare Advantage plans are required to accept out-of-network care the same as if it was performed in network. This means that you can obtain care at any provider without worrying about being charged excess fees. Medicare Advantage plans have out-of-pocket annual maximum limits, and most plans include prescription medication coverage.
Does Medicare Cover Coronavirus Testing?
Many people want to get tested to see if they have COVID-19. The good news for Medicare recipients is that insurance will provide coverage for COVID-19 testing. This testing can be conducted at community testing sites, including drive-through and hospital off-site locations.
Medicare will cover coronavirus testing for current infection swab tests and for serology testing to determine whether or not antibodies for the virus are present in the blood. These tests are covered under Medicare Part B. If you have a Medicare Advantage plan, this testing will be covered as well because MA plans must cover all Part A and Part B services.
For most services or diagnostic tests, recipients are responsible for paying towards their Part B deductible and a 20 percent coinsurance payment. However, the Families First Coronavirus Response Act has also eliminated any associated out-of-pocket testing costs for recipients. This means that COVID-19 testing does not carry any coinsurance payment and does not affect your deductible amount.
If you experience symptoms, contact your doctor immediately. Medicare coverage will include telehealth or in-person visits to a physician office, emergency department, urgent care, or hospital observation unit. If your doctor sends you to get tested, all associated costs will be covered.
Would a Coronavirus Vaccine be Covered?
If a vaccine is developed for the coronavirus, all Medicare recipients will be able to receive the vaccine free of charge. Normally, preventive vaccines are covered by Medicare Part B, and the coinsurance and deductible payments do not apply in these cases.
How Can Medicare Help Me During the COVID-19 Pandemic?(Opens in a new browser tab)