Medicare Coverage of Pre-Existing Conditions With Increased COVID-19 Risk

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While so much remains unknown about the deadly novel coronavirus (COVID-19), experts agree that those with certain pre-existing conditions may be at a greater risk of health complications or death if infected by the virus.

Medicare provides coverage for a range of preventive care, screening and treatment for some of the pre-existing conditions that have been identified as high-risk for COVID-19 complications.

Here is a look at some of the pre-existing conditions that increase one’s risk for serious COVID-19 infection and how Medicare benefits may help.

Heart disease

The fever associated with COVID-19 places additional strain on the heart, which can be deadly when the heart is already weakened. COVID-19 can also lead to inflammation of the lining of blood vessels that work with the heart.

Medicare Part B (medical insurance) can cover a variety of services associated with heart disease, including:

• Cardiovascular disease screenings
• Cardiovascular behavioral therapy
• Cardiac rehabilitation programs
• Defibrillators
• Pulmonary rehabilitation programs

Medicare Advantage (Medicare Part C) plans are required to cover everything that Original Medicare (Part A and Part B) covers. This means Medicare Advantage plans also cover screenings and treatments for heart disease and other cardiovascular disorders that Original Medicare covers.

Chronic respiratory disease 

Chronic obstructive pulmonary disease (COPD) and other respiratory diseases like asthma and pulmonary hypertension create an increased risk for severe symptoms of COVID-19.

COVID-19 can lead to pneumonia, which compromises the lungs and further complicates a respiratory disease, making COVID-19 potentially lethal. 

Medicare Part B covers a rehabilitation program for severe COPD designed to help patients breathe easier, increase strength and stamina and live more independently. 

Medicare also provides coverage for oxygen equipment and other respiratory assistance devices like continuous positive airway pressure (CPAP) devices in certain circumstances.

Diabetes

Diabetes compromises the immune system, making it harder for the body to ward off illnesses. And many viruses tend to thrive when blood glucose levels are high, which is the case for those who are diabetic.

Medicare Part B provides coverage for the following items and services related to diabetes:

• Up to two diabetes screenings per year
• Diabetes prevention program
• Therapeutic continuous glucose monitors (CGMs)
• Diabetes self-management training
• Eye exams for diabetes
• Nutrition therapy services 
• Foot care for diabetes and therapeutic shoes and inserts 
• Blood sugar test strips and related supplies 
• Lancets and lancet devices 
• Blood sugar monitors 

A Medicare Part D or a Medicare Advantage plan that includes prescription drug coverage may cover diabetic supplies such as insulin and other devices. 

Depression and anxiety

Fear of COVID-19 can cause increased anxiety, especially for people who already suffer from anxiety or depression.

Medicare Part B covers one depression screening per year along with a variety of outpatient mental health services. Medicare Part A provides coverage for inpatient mental health care.

Some Medicare Advantage plans may cover services such as a nurse help hotline or telemedicine conferences with a health care provider such as a psychiatrist.

If Medicare Part A or Part B covers your testing or treatment for the above health conditions, a Medicare Supplement plan (Medigap) can help pay for some of your out-of-pocket Medicare costs such as deductibles, coinsurance and copayments.

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.