Are Coronavirus Tests and Treatments Costs Covered under Medicare Plans?

Coronavirus Tests and Treatments Costs under Medicare Plans

With coronavirus dominantly affecting the people around the world, healthcare institutions like U.S. Centers for Disease Control and Prevention, are continuously issuing public guidelines to make them follow safety protocols so that they remain vigilant and protected. The government doesn’t want cost to be a barrier for people to obtain testing or treatment for COVID-19, so the government-sponsored Medicare plans have responded to the coronavirus by giving Medicare enrollees access to COVID-19 testing and treatment. The 2020 COVID-19 pandemic started after a new virus SARS-CoV-2 was found in Wuhan, China. This virus is responsible for infecting millions of people in the United States, with numbers still increasing, with no proper treatment yet available.

Coronavirus is contagious and spread from person to person mainly through the air via particle transmission. It is due to this reason people are advised to wear masks, regularly wash their hands, and avoid public spaces is possible. However, the majority of the people who contracted this virus recovered and returned to normal lives but some people may get adversely affected and may need intensive treatment. Currently, there is no cure for COVID-19, as patients are just given supportive medical interventions to reduce symptoms. Some of the patients face severe complications like organ failure, respiratory failure, and sepsis leading to even death.

Are Medicare beneficiaries at Higher Risk for Coronavirus?

Medicare beneficiaries who are generally disabled or of advanced age are at great risk of contracting coronavirus, as both elderly and disabled have poor immunity and their respiratory system is already compromised. Such patients find it difficult to recover from COVID-19. Besides, coronavirus also adversely impacts their health. Thus, it is imperative for the Medicare beneficiaries to be aware of the COVID-19 tests and treatments and whether these are covered under the Medicare plans or not.
The COVID-19 incubation period is somewhere between 2 to 14 days, during which an infected person can expose other people to the virus before showing any symptoms. The infected person may not even realize that they have been infected for up to two weeks. Therefore, Medicare beneficiaries need to communicate with their healthcare provider on experiencing any issue, even if it is a small one. The elderly can also make use of the telehealth facility whenever possible to get in touch with their doctors on experiencing even mild symptoms of this virus. Some of the common symptoms of this virus include:

  • Cough
  • Fever
  • Body aches
  • Sore throat
  • Taste or Smell loss
  • Extreme fatigue
  • Chest pain
  • Difficulty breathing
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The rising cost of healthcare acts as a deterrent for seniors on a fixed income to avail tests and treatment so the government is taking necessary steps to ensure that people don’t avoid getting tests and treatments.

About Coronavirus Tests

To confirm active COVID-19 infection two types of diagnostic coronavirus tests molecular tests and antigen tests are conducted. Both these tests are either performed in the laboratory or at designated testing sites. Molecular COVID-19 tests either confirm or rule out the presence of coronavirus by detecting the virus’s genetic material. A molecular test is highly accurate and is conducted by taking saliva from the throat or mucus sample from the nasal passage. Antigen Covid-19 tests look for proteins from the coronavirus and provide results in as little as 15 minutes, though there is a great chance of error in this test. This test is conducted by taking a nasal swab.

Medicare Provide Coverage for COVID-19 Tests and Treatments

Medicare beneficiaries should know that both Original Medicare Part B and Medicare Advantage plans provide coverage for COVID-19 testing. However, if beneficiaries have only Part A coverage and they have delayed enrollment in Medicare Part B, and they have undergone COVID-19 testing in an outpatient setting, then their testing will not be covered. The majority of the Medicare beneficiaries having both Part A and Part B or a Medicare Advantage (Part C) plan, testing for COVID-19 is covered with no cost share. Find some more information about Part B coverage related to COVID-19 testing:

  • Medicare provides coverage for the tests of COVID-19 conducted at a “parking lot” testing website.
  • Medicare beneficiaries can receive COVID-19 tests free of cost if they get the test done from a physician, pharmacy, laboratory, or from an approved testing site.
  • Even the antibody test of COVID-19 is covered under Medicare, though the result is not solely relied upon as evidence of active infection.
  • Any prescription medications that the seniors receive for COVID-19 treatment will be covered by Medicare.
  • Medicare will cover the inpatient stay for up to 60 days if beneficiaries get hospitalized because of COVID-19.
  • Costs of some additional tests that are performed to rule out an active COVID-19 diagnosis are also covered under Medicare.
  • Medicare also covers in-home testing for individuals who qualify for home testing.
  • Certain respiratory conditions tests that help in the diagnosis of coronavirus are also covered under Medicare.
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Does Medicare Cover COVID-19 Treatments?

COVID-19 like other medical conditions is a valid diagnosis that is covered under Medicare plans. Healthcare providers who accept Medicare assignments provide inpatient or outpatient services, coordinate therapies for COVID-19 patients, and request lab work. Healthcare providers who accept Medicare beneficiaries need to follow Medicare guidelines while submitting medical claims. Though coronavirus testing is free of cost but COVID-19 positive patients who need inpatient treatment will owe some out-of-pocket costs. While most of the COVID-19 patients safely recover at home but elderly with chronic health conditions are likely to need aggressive treatment.

Medicare beneficiaries are usually protected from most of these costs and their out-of-pocket cost will mainly depend on whether they have Original Medicare or an Advantage plan. As per the Kaiser Family Foundation, on average beneficiaries of Medicare Advantage with fewer than five days hospital stays will pay less than the beneficiaries of Original Medicare, but Medicare Advantage beneficiaries would face higher costs for stays longer than seven days. Thus, Medicare beneficiaries with no supplemental coverage under Original Medicare will owe a $1,408 deductible for each hospitalization with no additional Part A costs. Beneficiaries will also owe 20% of the Medicare-approved cost for physicians’ services while they are inpatient after paying the $198 Part B deductible.

Does the COVID-19 Vaccine covered under Medicare?

After working hard on COVID-19 vaccines, researchers have finally come across some viable options that they are making available to the public. The U.S. federal government has announced that Medicare beneficiaries will receive the vaccine at no cost, and Medicare will provide coverage for the vaccine and its administration. Medicare beneficiaries would also not require paying any deductibles, co-payments, and coinsurance.

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