What’s Changing in Medicare Post COVID

First, let’s take a look at Medicare coverage for testing Coronavirus. For testing, Part B covers you when you go to a laboratory, pharmacy, doctor, or hospital. The testing should take place in your local area. You won’t pay anything for the COVID test when you have Medicare. In some cases, Medicare covers a home health nurse, lab tech, or other medical assistants to collect your specimen in your home for the test. Further, Medicare covers tests at various locations, including “parking lot” testing sites. Next, Medicare covers coronavirus treatment, but some cost responsibility will fall on the beneficiary.

For example, Part A will cover inpatient hospital stays, home health visits, skilled nursing facilities, and hospice. But, Part A costs will apply to these services. Now, patients that require hospital quarantine when they would otherwise be discharged won’t need to pay an additional deductible.

Then, Part B will cover outpatient services such as doctor visits, ambulance transportation, and emergency room visits. But, beneficiaries that don’t have a Medigap plan will be responsible for deductibles and coinsurances. Part B will also cover a COVID-19 monoclonal antibody treatment if you test positive for COVID, have mild to moderate symptoms, and you’re at high risk for a severe case of COVID.

Insurance companies may consider COVID a pre-existing condition. But, Original Medicare is a public health program that covers people with pre-existing conditions. The bigger question, will Medigap consider COVID a pre-existing condition? Again, it’s possible. That’s why it’s important to sign up for Medigap during the Medicare Supplement Open Enrollment Period.

COVID is increasing patient access to both telehealth and mental health services. In response to the public health emergency, there was a Medicare expansion on telehealth. The expansion took place to help patients and doctors maintain social distancing measures. Medicare acknowledges the stress people are experiencing due to the pandemic. In a post-COVID America, increased access to mental health care will be a high priority. Prolonged isolation and living through a global pandemic increase the need for therapy. Plus, most mental health care services can now take place through telehealth.

Medicare Advantage plans must cover at least as good as Medicare. So, Part C plans can’t charge any copayments or coinsurances for tests to detect or diagnose COVID-19.  Cost-sharing for COVID-19 treatment will vary across Medicare Advantage plans. But, many Medicare Advantage insurers will waive coronavirus cost-sharing; this isn’t a requirement, though. Also, plans may waive prior authorizations for services relating to COVID.

Some carriers are going to apply a smaller increase at the beginning of the year and then implement the full increase later during the year. The reason for doing this is to try to keep rate increases lower during the pandemic. If you receive a letter from your company with similar information, you can call the carrier to ask any questions.

Yes, Medicare will cover three at-home COVID tests. The costs can range from $25 – $50. These tests include:

• Ellume COVID test
• Abbott’s BinaxNOW COVID-19 Ag Card Home Test
• Lucira COVID-19 All in One Test Kit

The accuracy of these tests is above 90%. Also, the FDA has given these three tests “emergency use authorization.” So, even though they haven’t gone through rigorous approval, they needed to be on the market swiftly due to the pandemic.

Yes, more than half feel comfortable receiving the vaccine.