If you are a Medicare agent, you may be wondering if there is coverage for COVID-19. The short answer is, yes, coronavirus (COVID-19) testing and treatment is covered by Medicare. Part B (outpatient services) covers testing costs, however, only when your doctor or other health care provider who accepts Medicare, orders the test. This is true if you are enrolled in Original Medicare or Medicare Advantage. Deductible and co-pay costs have also been waived along with associated services such as physician visits or hospital observation.
According to the Centers for Disease Control and Prevention (CDC), older adults and people who have severe chronic medical conditions like heart, lung, or kidney disease are at higher risk for more serious COVID-19 illness. Because Medicare’s beneficiaries are among the most vulnerable to COVID-19, the agency is relaxing some of its rules and expanding some of its services in response to the virus.
Will Medicare cover COVID-19 treatment?
Yes, if your Medicare clients get coronavirus (COVID-19), Original Medicare will cover treatment as if they were sick with any other illness. Outpatient services are covered under Part B. Medicare Part A (hospital services) will cover in the event they need hospitalization. This includes a deductible of $1,408 for each stay, and a daily co-pay if the hospital stay exceeds 60 days.
If you have Medicare Advantage clients, hospitalization costs vary based on the plan and the length of the hospital stay. A New York Times article reports that a study by the Kaiser Family Foundation found for hospital stays of five days or more, at least half of Medicare Advantage enrollees “would pay more than the deductible paid by traditional Medicare enrollees without supplemental coverage.” In contrast, many supplemental policies will cover 100% of Orignal Medicare’s deductible and co-payments.
Telehealth during Covid-19
CMS has expanded telehealth coverage, which had previously been restricted from Medicare coverage. Patients are now able to connect with any doctor from their home via video on a smartphone or other digital device.
Medicare coverage of a COVID-19 vaccine?
Currently, there is no vaccine to prevent COVID-19 infection, nor is there a specific timeline when it will become available. If a vaccine does become available, however, Medicare will cover it under Part B.
The best way to prevent this illness is to avoid being exposed to the virus. The CDC recommends everyday preventative actions for this and other respiratory illnesses, including:
- Wash your hands often with soap and water
- Cover your mouth and nose when you cough or sneeze
- Stay home when you’re sick
- See your doctor if you think you’re ill
As we continue on this coronavirus journey, remember to keep your health and your clients’ health, at the forefront. Remember, your Medicare clients may be concerned about what their Medicare coverage would be for hospitalization. Reach out to them and put their mind at ease by going over their benefits.
Empower Brokerage is dedicated to helping you educate your clients on the insurance they need to get the most out of life. Whether it’s through webinar training, one-on-one calls, seminars, or marketing plans. We want you to be successful. Give us a call if you have any questions 888-539-1633.