Coronavirus News and Resources for Medicare Beneficiaries
Below is a guide to help Medicare beneficiaries stay informed and better protect themselves against the coronavirus, including how Medicare coverage can help.
What COVID-19 treatment and testing does Medicare cover?
Original Medicare (Medicare Part A and Part B) and some private Medicare Advantage (Medicare Part C) plan carriers and Part D prescription drug plan carriers are responding to the pandemic in a number of ways.
COVID-19 testing with $0 copays, coinsurance and deductibles
Medicare Part B and Medicare Advantage plans cover any COVID-19 test that was ordered after February 4, 2020, and is ordered by a doctor or other health care provider who accepts Medicare.
No prior authorization is required. There are also no required out-of-pocket costs such as copays, coinsurance or deductibles for an approved coronavirus test or for a doctor’s office visit to be tested.
Virtual doctor visits
Some Medicare Advantage plan carriers such as Humana, Aetna and Anthem offer telemedicine services such as virtual doctor’s office visits by video or telephone, and some plans offer nursing hotlines you can call for answers to your health questions.
Medicare Part B has also expanded its coverage of telemedicine services.
Early prescription refills and up to a 90-day supply
Some Medicare plans that offer prescription drug coverage now allow early filling of prescriptions and for an extended supply of certain drugs, up to a 90-day supply.
Additionally, some Medicare plan carriers are also offering benefits such as:
Fee waivers for home delivery of prescriptions
Online and on-demand exercise and wellness videos from the SilverSneakers program
Free home delivery of select over-the-counter (OTC) items
Medicare Supplement Insurance (Medigap) plans will typically continue to cover the same out-of-pocket Medicare costs such as copays, coinsurance and deductibles that they covered before the novel coronavirus outbreak.
Check with your Medigap plan provider regarding any changes or updates to your coverage.
Are telehealth services for COVID-19 covered by Medicare?
Medicare does cover telehealth services related to COVID-19. In fact, the Centers for Medicare & Medicaid Services (CMS) has actually expanded Medicare coverage of telemedicine services due to the outbreak.
Health care providers can conduct video consultations with patients who are experiencing symptoms consistent with COVID-19. This allows seniors to remain in the safety of their home while receiving care, as opposed to risking the contraction or spread of the infection by visiting a doctor’s office.
Can I stock up on extra medication if I have to quarantine?
When COVID-19 was declared a national emergency, the rules for refilling certain prescription medications were loosened.
Medicare Part D plans and Medicare Advantage plans that include prescription drug coverage are now allowed to relax their “refill-too-soon” restrictions. This allows beneficiaries to stock up on an extended supply of their medications.
If clinics and hospitals become overcrowded because of the outbreak, do I still have to remain in my plan’s network to receive care?
Because the COVID-19 outbreak was declared a national emergency, Medicare Advantage and Medicare Part D beneficiaries are able to receive qualified care outside of their plan’s network, if their Part D plan or Medicare Advantage plan includes a network of providers.
During the period of declared emergency, Medicare Advantage plans are required to cover services at out-of-network facilities that participate in Medicare and charge the beneficiary a rate that is no more than what they would have paid at an in-network facility.
Part D plans must also ensure members have adequate access to covered medications at out-of-network pharmacies when the use of an in-network facility cannot be reasonably expected.
Part D plans are also given freedom to relax rules about mail-delivered medications.
Will Medicare cover treatment for COVID-19?
There is currently no vaccine treatment for COVID-19. People who are infected with the virus can only be treated for the symptoms it causes.
Any treatment administered for the symptoms of COVID-19 will be covered in the same way those services and items are already covered by Medicare.
The treatment methods being used to address the symptoms of COVID-19 include:
- Medication to reduce fevers
- Fluids to reduce dehydration
- Respirators for supplemental oxygen
Medications used to treat a fever may be covered by a Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug benefits.
Supplemental oxygen is typically covered by Medicare Part B. Medicare Part A covers inpatient hospital stays, while outpatient visits are covered by Part B.
If you are admitted for inpatient hospital care, your Medicare Part A deductible applies. The Part A deductible is $1,408 per benefit period in 2020.
If you receive medical care for symptoms of COVID-19, you’re typically responsible for 20 percent of the Medicare-approved amount for covered services after you meet your Part B deductible. In 2020, the Part B deductible is $198 per year.
Medicare Supplement (Medigap) plans can help pay for some of the out-of-pocket Medicare costs listed above, such as the Medicare Part A deductible and Medicare Part B copays or coinsurance.
Will Medicare cover a COVID-19 coronavirus vaccine?
There are currently no FDA-approved vaccines for COVID-19.
The first clinical trial for a COVID-19 vaccine got underway on March 17. Senate minority leader Chuck Schumer previously called on Medicare to provide coverage for a novel coronavirus vaccine when one becomes available.
I live in a nursing home. Are there any special rules that apply to me?
Yes. Due to the novel coronavirus outbreak, the CMS has implemented the following Medicare nursing home guidelines:
Visitation will be largely restricted to end-of-life situations
All volunteers and nonessential personnel will be restricted
Group activities and communal dining will be cancelled
Residents and staff will be actively screened for fever and respiratory symptoms
Nursing homes are also taking extra steps as recommended by the Centers for Disease Control and Prevention (CDC), including stocking extra soap and sanitizer and making face masks, disinfectant and personal protective equipment readily available.
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Coronavirus (COVID-19) FAQ
What is coronavirus (COVID-19)?
Coronaviruses are a large family of viruses that cause anything from the common cold to more severe diseases like Severe Acute Respiratory Syndrome, or SARS.
Novel coronavirus is a new strain that has not been previously identified in humans. This strain leads to a disease called COVID-19.
How does coronavirus spread?
Coronaviruses are zoonotic, meaning they are transmitted to humans from animals.
For example, SARS was initially transmitted from a cat, and MERS (Middle East Respiratory Syndrome) was first transmitted to humans from a camel.
It is not yet known which animal may have been the source for the newest strain of coronavirus, but it first surfaced in the Chinese city of Wuhan (which has a population of over 11 million people) in December.
Once coronavirus is transmitted to humans, it spreads from person to person through respiratory droplets that are coughed, sneezed or exhaled into the air by the infected person and inhaled by another. These droplets can be inhaled by anyone within approximately six feet of an infected person.
Coronavirus can also live on surfaces such as door handles or tables and be spread by touching your mouth or nose after coming into contact with the infected surface.
It is estimated that each infected person will infect on average 2-3 additional people. It is currently believed that only those who are experiencing symptoms may transmit the disease or at the least, those with the most symptoms are the most contagious.
Who is affected the most by coronavirus?
Older adults and those with underlying medical conditions such as diabetes, high blood pressure, cardiovascular disease, respiratory disease and cancer are most at risk.
A study in China showed that the average age to develop acute respiratory distress syndrome –or severe shortness of breath that requires the use of a ventilator – as a result of coronavirus is 61 years old.1
Older adults may also be at a higher risk of being exposed to the coronavirus. Millions of seniors reside in senior living communities, assisted living homes or nursing homes, putting them in close contact with other seniors.
Most of the first-reported COVID-19 deaths in the U.S. have been traced to a nursing home in Seattle, Washington.
Children appear to be at less of a risk. One study from the China Center for Disease Control and Prevention (CCDC) found that just 2% of coronavirus cases affected children under 18 years old, and of those, only around 3% developed a severe case of COVID-19.2
What are the common coronavirus infection symptoms?
Coronavirus infection symptoms typically appear 2-14 days after exposure to coronavirus and include:
Shortness of breath or breathing difficulties
COVID-19 may also bring persistent pain or pressure in the chest and a bluish discoloration in the lips or face.
More severe cases can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
The global mortality rate for COVID-19 has been estimated at nearly 5%, though that number may exaggerate the lethality of the disease, as not all cases of infection are reported.3
Some people who have tested positive for the coronavirus have shown only mild symptoms or no symptoms at all.
How is COVID-19 treated?
There is no current treatment for the coronavirus or COVID-19 itself. Infected persons are treated for their symptoms, such as taking steps to alleviate their fever and suppress their cough.
Supportive care such as oxygen therapy and fluid management can also be effective treatment for symptoms.
Free coronavirus testing in the U.S
Coronavirus testing has been made free for people in the United States who have health insurance.
There are a few different ways to test for COVID-19.
A swab is used to collect a sample from the nose or mouth
A saline solution is injected into the nose and then removed with suction
A thin tube is inserted down the mouth and into the lungs to retrieve a sample
Sputum is a thick mucus that is coughed up from the lungs that can be collected in a cup or with a swab
A blood sample is taken from a vein
Only certain facilities have been approved for coronavirus testing. If your health care provider thinks you should be tested for coronavirus, they will contact the Centers for Disease Control (CDC) and refer you to a facility approved for testing.
Coverage of the test is protected as an essential health benefit as dictated by the Affordable Care Act.
The coronavirus test is covered by Medicare Part B, and you will pay nothing out-of-pocket for it if you are a Medicare beneficiary.
What should seniors do to stay safe from coronavirus?
There are a number of things seniors can do to reduce their risk of exposure to the coronavirus.
Avoid touching your eyes, nose and mouth.
Only touch hard surfaces in public when necessary.
Wash your hands with soap for at least 20 seconds multiple times per day, especially after using the restroom and being out in public.
Avoid close contact with others.
Use disinfectant on doorknobs, light switches, drawer handles, countertops, telephones and other surfaces that are frequently touched.
Practice good health habits like getting plenty of sleep, eating a healthy diet, exercising, and drinking a lot of fluids.
Postpone any medical or dental appointments that are not urgent or immediately necessary. Health care facilities may be more susceptible to carrying the virus due to the number of sick people who frequent them each day.
Keep an adequate supply of food and household necessities along with at least a 30-day ration of any prescription medications, if possible. Consider using a mail-order prescription service to avoid trips to the pharmacy.
Consider using a home delivery service for groceries and meals.
Stay tuned to your local public health agency and local news outlets for updated information about the outbreak in your community.
Face masks may help prevent the spread of the coronavirus from infected people. However, they are not believed to reduce the odds of contracting the coronavirus.
The latest Medicare news and updates on COVID-19
As of April 3, 2020, COVID-19 has infected 239,279 Americans, resulting in 5,443 total deaths.4
Refer to the list below to stay up to date on the latest news related to COVID-19, the current coronavirus pandemic and what you may need to know as a Medicare beneficiary.
Be sure to check back in with this list so that you don’t miss important updates.
CARES Act Economic Stimulus Money: Frequently Asked Questions
The federal government will issue stimulus checks to millions of Americans to help keep the economy afloat during the COVID-19 outbreak.
Some Private Medicare Plan Carriers Waive Cost-Sharing for Coronavirus (COVID-19) Treatment
Several private Medicare plan providers, including Cigna, Humana and Aetna, have taken measures to reduce or eliminate out-of-pocket costs (such as copays and deductibles) for plan beneficiaries who undergo treatment for COVID-19.
The CARES Act Economic Stimulus Package and Its Effect on Medicare
The Coronavirus Aid, Relief and Economic Security (CARES) Act economic stimulus package is set to make a sizable impact on the health care industry in America.
29 States Granted Medicaid Waivers Amid COVID-19 Outbreak
The Centers for Medicare & Medicaid Services (CMS) has approved the Medicaid waiver requests of 29 states under section 1135 of the Social Security Act in response to the COVID-19 outbreak.
Study: Medicare Spending Could Reach $115 Billion on COVID-19 Care
The COVID-19 pandemic has the potential to inflate Medicare spending by up to $115 billion over the next year, according to a recent study released by the National Association of Accountable Care Organizations.
Medicare Investigation of Kirkland, WA, Nursing Home Results in New Inspection Protocols
Medicare completed an inspection of the nursing home in Kirkland, WA, that was the epicenter of the novel coronavirus outbreak in America.
Medicare Helps Doctors on Coronavirus Front Line by Extending Deadline for Quality Reporting
Medicare is easing the burden being faced by doctors during the coronavirus (COVID-19) outbreak by extending the deadline for quality reporting measures.
The deadline for reporting results has been extended in order to allow doctors on the front lines of the outbreak to focus on patient care.
Medicare to Hospitals: Halt Nonessential Surgeries and Dental Care in Wake of COVID-19 Outbreak
The Centers for Medicare & Medicaid Services (CMS) has urged hospitals to delay nonessential surgeries to free up staff and resources for the wave of COVID-19 patients.
Medicare Expands Telemedicine Coverage in Fight Against COVID-19
The Centers for Medicare & Medicaid Services will expand telemedicine services coverage nationwide in an effort to help seniors receive medical attention from the safety of their own homes and to help curb the spread of the novel coronavirus (COVID-19).
CMS Takes Measures to Help Nursing Homes in Fight Against COVID-19
Medicare is taking steps to keep nursing home residents safe amid the COVID-19 outbreak. Because nursing home residents are older and in close proximity to other older adults, nursing homes have become a dangerous breeding ground for the virus.
Declaration of Emergency for COVID-19: What Does it Mean for Medicare?
Declaring the outbreak of COVID-19 a national emergency opened some doors for Medicare to take more aggressive steps in its fight against the pandemic.
Medicare Announces Reimbursement Rates for Coronavirus Testing
Medicare recently released details about how COVID-19 testing would be reimbursed to health care providers administering the tests.
Federal Medicare Coronavirus Guidance for Private Insurance Plans
In the wake of the novel coronavirus pandemic, the CMS released guidance on how Medicare Advantage and Medicare Part D prescription drug plans can properly respond to the outbreak.
Coronavirus Test to Be Covered by Medicare
Vice President Mike Pence announced during a March 4 press briefing that the test for COVID-19 will be covered by Medicare and Medicaid, in addition to private insurance.
Senator Schumer to Calls for Medicare to Cover Vaccine
Schumer called for Medicare to cover the vaccine when one does become available, saying at a press conference that his plan to have Medicare fully cover the cost of the vaccine “will mean no senior will be forced to make the choice between shelling out and going without.”
Additional coronavirus resources for seniors
Below are some resources for updated news, information and tips about the coronavirus and COVID-19 that may be helpful to seniors:
Centers for Disease Control and Prevention
Stay up to date with the latest national coronavirus information from the CDC.
American Red Cross
Check out these safety tips and updates from the American Red Cross.
World Health Organization
The World Health Organization put together this instruction manual about how to care for someone at home who is suspected of having COVID-19.
Harvard Medical School
Explore these tips for caregivers who may be caring for someone with COVID-19, especially those who are caring for older parents.
U.S. Department of Education
The U.S. Department of Education compiled these helpful resources for teachers and other educational professionals looking to stay safe and healthy during the COVID-19 pandemic.
United States Department of Labor
The U.S. Department of Labor compiled this extensive list of coronavirus resources for working professionals from a number of different fields.
1 Yanli Liu, et al. (Feb. 27, 2020). Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. medRxiv. https://doi.org/10.1101/2020.02.17.20024166.
2 The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020[J]. China CDC Weekly, 2020, 2(8): 113-122.
3 Worldometer. COVID-19 Coronavirus Outbreak. Retrieved April 1 from www.worldometers.info/coronavirus.
4 Center for Disease Control and Prevention (CDC). (April 3, 2020). Coronavirus Disease 2019 (COVID-19) in the U.S. Retrieved April 3 from www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html.
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.