Does Medicare Cover COVID-19 Testing and Vaccines?

For Medicare beneficiaries and people newly eligible for Medicare, it's important to know whether you would have coverage for COVID-19 testing and vaccinations. Many people are still waiting to be vaccinated, and regardless of vaccination status, some jobs and services are requiring a negative COVID-19 test.

While Medicare has evolved to offer a breadth of coverage for COVID-related care, 1 in 6 people aged 65 and older had difficulty signing up for a COVID vaccine, according to a March 2021 study from the Kaiser Family Foundation. As this age group is also one of the most affected by Coronavirus, it's particularly important to know how to get a free and accessible vaccination.

To help, we'll break down just what Medicare covers, including COVID-19 testing, vaccinations and other related resources.

Which Medicare plans cover COVID-19 care?

Medicare is divided into three main types of programs:

  • Original Medicare. This is a basic federal health insurance program for people 65 and older, and younger people with qualifying disabilities. Part A covers care for stays in hospitals, hospice and nursing facilities. Part B covers doctor visits, outpatient care and medical supplies. Part D covers prescriptions drugs and vaccines.
  • Medicare Advantage. Also known as Part C, this is a private alternative to Original Medicare with all the same benefits. It may also offer extra coverage, such as for dental and vision care and longer hospital stays. However, members have to use doctors in their plan's network to keep costs low.
  • Medicare Supplement. Also known as Medigap, Medicare Supplement plans fill in the gaps of Original Medicare coverage. The biggest benefits of these plans include lower copayments, coinsurance options and deductibles. They may also cover medical emergencies while traveling abroad.

All three of these Medicare programs provide the same COVID-19 coverage, which is outlined below.

Does Medicare cover COVID-19 testing?

Under Part B, Medicare covers all major COVID-19 tests, including:

  • Diagnostic tests for COVID-19 taken in a lab, pharmacy, doctor's office, hospital or, in certain cases, the home
  • COVID-19 antibody tests for those diagnosed with or suspected to have the disease, to see whether they've developed an immune response

Medicare covers all costs for these tests, including copays and deductibles so those covered don't have to pay anything out of pocket.

Does Medicare cover COVID-19 vaccinations?

Medicare covers FDA-authorized COVID-19 vaccines at no cost to its members. There will be no copayment, deductible or coinsurance. Just be sure to bring your Medicare card or number to the vaccination site. 

While vaccines are often administered in pharmacies, doctors' offices and hospitals, Medicare will also pay for a care provider to administer the vaccine at home in case of a disability or difficulty traveling. 

Will Medicare cover you if you get COVID-19?

While mild cases of COVID-19 may be treated at home with rest and fluids, more severe cases may require hospitalization and treatments such as IVs and ventilators. Medicare covers all medically necessary hospitalizations, including those for COVID-19. Even if you're healthy enough to be discharged but are required to stay in the hospital under quarantine, Medicare will cover your care.

As mentioned above, Medicare Part A covers inpatient care, Part B covers outpatient care and Part D covers prescription drugs. FDA-approved COVID-19 medications such as remdesivir are covered by Medicare, for example. Medicare will also cover monoclonal antibody treatments, which may be given to those who've tested positive for COVID-19. You will, however, have to pay for any hospital copays, deductibles and coinsurances that apply under your specific plan.

Does Medicare cover additional COVID-19 care?

Some Medicare plans offers additional services that may be helpful for those affected by COVID-19, including:

  • Telehealth services for at-home care
  • Transportation to medical facilities
  • Meal delivery

In response to the pandemic, Medicare also relaxed its rules for drug authorizations so people can access medicine more easily and allowed coverage in certain out-of-network healthcare facilities.

Source: iQuanti, Inc.

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Categories: Healthcare Insurance

Tags: COVID-19, COVID-19 vaccine, health insurance, medicare