As the US enters its second year of the coronavirus pandemic, the country has run more than 360 million tests for COVID-19 and continues to introduce millions of vaccines. It wasn’t seamless – roughly one in six 65-year-olds tried not to sign up for a vaccine, according to a recent report from the Kaiser Family Foundation. Of 4 older adults who were successfully vaccinated or tried to enroll, around 4 in 10 said it was difficult to do.
For the 61 million Americans who are covered by Medicare and Medicare Medicare advantage Plans, vaccines, and testing for COVID-19 are covered by Medicare, but details can be difficult to pin down. Since the beginning of the pandemic, the Centers for Medicare & Medicaid Services (CMS) have adjusted Medicare rules to meet the requirements related to COVID-19. Here is a quick overview:
Does Medicare Cover COVID-19 Tests?
Yes, Medicare Part B. (Health insurance) covers all costs for tests to see if you have COVID-19. You do not need a doctor’s order and you are covered for tests that you can get from a laboratory, pharmacy, doctor or hospital. In some cases, a home nurse, laboratory technician, or trained medical assistant may be able to perform a test at your home. If you have a Medicare Advantage plan, it must cover everything that Medicare Part A or Part B would cover.
Tests to diagnose or diagnose COVID-19.
Some tests for related respiratory diseases used to diagnose COVID-19 are done along with a COVID-19 test.
Tests on some parking lots.
If you have been diagnosed with COVID-19 or are suspected of having COVID-19, Medicare Part B also covers COVID-19 antibody tests that have been approved by the Food and Drug Administration. These tests are also known as serology tests and can indicate whether you have developed an immune response to COVID-19.
Medicare and Medicare Advantage cover all COVID-19 testing and COVID-19 antibody testing costs, including copays, deductibles, and co-insurance.
Does Medicare Cover Treatment Costs For COVID-19?
Yes, Medicare covers a wide variety of treatment costs related to COVID-19. For example, Medicare will cover monoclonal antibody treatments where people who test positive for COVID-19 with mild to moderate symptoms will receive antibodies made in a laboratory.
Medicare also covers required hospitalization due to COVID-19, including any days you would normally have been released from inpatient care but need to remain in hospital for quarantine. For the hospital stay, you are responsible for all applicable deductibles, co-payments and co-insurances in the hospital.
For example, if you have Original Medicare in 2021, you will pay a Part A deductible of $ 1,484 before coverage begins for the first 60 days of hospitalization, unless you have supplemental insurance (or Medigap) to cover your deductible. When you have Medicare Advantage, your deductibles, co-payments, and co-insurances vary depending on the plan.
Does Medicare Cover the COVID-19 Vaccine?
Yes, Medicare will cover all costs for vaccination shots for COVID-19. There is no deductible, copay or administration fee. Make sure you have your Medicare card or Medicare number with you – even if you’re on a Medicare Advantage plan – so the doctor or pharmacy can bill Medicare. If you have Medicare Part B and need to fill out a form to receive the vaccine, please leave a “Group Number” field blank or type “N / A”.
Medicare Advantage plans must provide the same benefits as Medicare Part A and Part B and may offer additional benefits. So check your specific plan for details.
To find out more about vaccines in your area, contact your state or local health department or visit their website. The VaccineFinder The Centers for Disease Control and Prevention has a drop-down list of states and territories that will direct you to the right place.
If you have any questions about coverage or the cost of Original Medicare, call Medicare at 800-633-4227 or visit Medicare.gov.