Medicare covers medical services that are medically necessary to diagnose, treat, and prevent health conditions. Coronavirus is no exception. Medicare covers diagnostic testing, treatment, and more for coronavirus. Now that you know Medicare covers medical services related to coronavirus, you should learn how Medicare covers these things and your expected costs out of pocket.
Medicare coverage for coronavirus testing
The diagnostic test to verify whether you have COVID-19 or not is performed by a medical professional who inserts a long cotton swab through your nostril. They will swab the back of your nasal cavity and submit the swab to be tested for COVID-19.
The COVID-19 diagnostic test is covered by Medicare Part B. Generally, Medicare Part B covers outpatient medical services at 80%. However, there are a few services that Part B covers at 100%. For example, Part B covers preventive services, such as diabetes screenings, bone density scans, and mammograms, at 100%. The COVID-19 test is also covered at 100% by Part B.
You can have the COVID-19 test administered many places, and Medicare will cover it. For example, you can get your test done at a pharmacy, doctor’s office, lab, hospital, or your home (in some cases), and Medicare will cover it.
The COVID-19 antibody test
The COVID-19 antibody test detects whether you have been infected by SARS-CoV-2 in the past or not. If the test comes back positive for COVID-19 antibodies, you may have developed an immune response to the disease. Medicare Part B also covers this test at 100%.
Medicare coverage for coronavirus treatment
According to the Centers for Disease Control and Prevention (CDC), there is no specified treatment for getting rid of COVID-19. Most prescribed treatments for COVID-19 may include at-home self-care, virtual check-ins with your doctor, and hospitalization in more severe cases.Medicare will cover the medically necessary services you need to treat COVID-19.
Prior to the coronavirus pandemic, Medicare covered virtual check-ins with doctors (also called telemedicine), but only in certain situations. Now, because of the pandemic, Medicare has loosened its requirements for covered telemedicine services.
Telemedicine services include doctor visits, psychotherapy sessions, and other types of doctor-patient consultations. You and your doctor will need a two-way telecommunication system that includes video and audio. If your doctor accepts Medicare assignment, then Part B will cover 80% of the claim, and you will cover 20%.
If your doctor recommends hospitalization to treat your disease, Medicare Part A and Part B will work together to cover your treatment while in the hospital. Medicare Part A will cover your stay, while Part B will cover your doctor services during your stay.
You will be responsible for your normal Part A and Part B cost-sharing expenses, such as the Part A and B deductibles and Part B coinsurance. However, if you have a Medigap plan that covers most of these expenses, you may be responsible for very little.
For example, if you have a 15-day stay as an inpatient, you would be responsible for your $1,408 Part A deductible, your $198 Part B deductible (unless you’ve met it prior to your stay), and your Part B 20% coinsurance. But if you had a Medigap Plan G, the only expense you’d be responsible for is the $198 Part B deductible.
Medicare coverage for the coronavirus vaccine
Although there is no established vaccine available today for COVID-19, Medicare will cover it once one is available. Medicare Part B and Part D both cover some vaccines. How Medicare decides which part covers a specific vaccine, no one knows. However, Medicare has officially stated that once a COVID-19 vaccine is created, it will be covered by all Part D plans – not by Part B.
It can be alarming if you’re told you have a confirmed diagnosis of COVID-19. However, with Medicare’s substantial coronavirus coverage, you can focus on getting healthy rather than bill piling up later.