COVID-19 has infected over 15 million people in the United States according to WorldoMeter. The virus primarily spreads from respiratory droplets released in the air from a cough, sneeze, or talking. There have been over 200,000 COVID-19 deaths in the United States with 8 out of 10 being seniors age 65 or older.
Because seniors are the most vulnerable to COVID-19, Medicare has adjusted its coverage to ensure seniors get the healthcare they need without exposing them to unnecessary risks. With the new Medicare changes, will Medicare cover COVID-19 treatment?
Medicare and COVID-19 testing
A COVID-19 test can tell doctors if you have a coronavirus infection. There are two different tests: the swab test and the antibody test. The COVID-19 swab test can detect if you have the disease at that moment. By contrast, the COVID-19 antibody test detects if you have coronavirus antibodies which indicate you had the virus in the past.
Medicare Part B covers both the COVID-19 swab and antibody test at 100%. Usually, you would pay the Part B deductible and/or coinsurance for an outpatient service. Medicare and Medicare Advantage plans waive all deductible and coinsurances for coronavirus testing administered by a doctor, hospital, pharmacy, laboratory, or select drive-through sites.
Medicare hospital coverage
If you become seriously ill with COVID-19 and require hospitalization, Medicare Part A would pay for your care. Part A covers your room, meals, medications, and lab services while you’re an inpatient in the hospital.
You must pay the Part A deductible, which is $1,484 in 2021, before Medicare covers your care. Medicare covers up to 60 days inside the hospital. After day 60 as an inpatient, you will pay a daily $352 copayment for days 61 through 90.
If you are well enough to be discharged but you need to remain quarantined for a period of time, Medicare will cover inpatient quarantine.
If your doctor recommends a stay at a skilled nursing facility after your inpatient stay to help you recover, Medicare Part A will cover the first 20 days of your skilled nursing facility stay as long as you were an inpatient for at least three days.
If you must stay longer than 20 days at a skilled nursing facility, you will pay a daily copayment of $185.50 for days 21 through 100. If you have a Medigap or Medicare Advantage plan, it will likely help with out-of-pocket costs.
Will Medicare cover the COVID-19 vaccination?
On December 12th, the FDA approved a Pfizer COVID-19 vaccine for emergency use. Plans are currently underway to begin administering the vaccine to those at highest risk.
Under the CARES Act passed by Congress in March, Medicare Part B will pay 100% of the costs of FDA-approved coronavirus vaccines. As soon as you are able to get the vaccine, Medicare will cover both the cost of the vaccine itself and the cost to administer it. You pay nothing out of pocket for the COVID-19 vaccine.
The coronavirus pandemic has disrupted every aspect of life, but there are hopeful signs now that an approved vaccine is in distribution. In the meantime, Medicare is there if you need a COVID-19 test or treatment. And as soon as you are able to get the vaccine, Medicare will pay 100% of the costs.