What’s Changing in Medicare Post-COVID?

The COVID-19 pandemic has been a worldwide game-changer for people of all ages, races, and health histories. However, most notably, COVID-19 has brought the most harm to those over age 65 and those who are immunocompromised. Predictably, it requires many adjustments from insurance companies, including Medicare, to combat these ever-changing times. During the pandemic and its aftermath, the availability of telehealth and mental health services through Medicare has increased and continues to expand.

When it comes to COVID coverage through Original Medicare, it is essential to understand your cost-sharing responsibilities for testing, treatments, and vaccines. Below, we review all of these details and help you understand your responsibility.

Update: President Biden Announces End to National Health Emergency

On January 30, 2023, President Biden announced his intent to end the national public health emergency related to the COVID-19 pandemic on May 11, 2023. This national public health emergency has been in place since early 2020 and has allowed for flexibility and modification of government programs, policies, and procedures, including Medicare.

While some states may continue to offer additional coverage or relief related to the pandemic, it will no longer be monitored or recognized at the federal level.

Does Medicare Cover At-Home COVID Tests?

Currently, private insurance companies in the United States are required to provide at least eight at-home COVID-19 tests. This includes all Medicare plans. All provided tests must be FDA-approved and available through certain pharmacies and other entities. As one of the most susceptible groups to the virus, seniors on Medicare can utilize these resources to acquire free at-home testing kits.

Due to the announcement of the end to the national health emergency related to COVID, legislation is changing. This means your plan may no longer provide free COVID testing kits. After May 11, 2023, those on Original Medicare will no longer be given free COVID tests. Additionally, those with Medicare Advantage plans are not guaranteed free tests. However, each insurance company will be able to decide if they will continue to provide free testing kits and in what quantity.

For those on a fixed income who may not have the resources to pay for COVID tests, when necessary, free pop-up clinics in your area may still be available as the pandemic comes to an end. 

Does Medicare Cover PCR and Rapid COVID Tests?

COVID Rapid and PCR tests are typically administered by a physician or other health professional. These tests are currently free to any person regardless of their insurance status. However, like at-home tests, these may no longer be free of charge to you once the pandemic is officially over.

If you are enrolled in Original Medicare, there will be no cost for the actual COVID test. Yet, you may see a charge for the administration of the test and the visit with your doctor. For those with a Medicare Advantage plan, costs will be determined by each individual plan, and there may even be a testing limit through your plan. So, you’ll want to be sure you understand your plan’s benefits when receiving care.

Does Medicare Cover the COVID-19 Vaccine?

Federally funded vaccines are available at no cost to you, regardless of your insurance status. Once the national health emergency is released in May 2023, vaccines will remain free of charge if the supply of federally funded vaccines is available. If you receive a federally funded vaccine, you or your insurance company cannot be charged.

Once the supply of federally funded vaccines is gone, it is speculated that the vaccine will remain free of charge to those with Medicare and other commercial insurance policies nationwide.

Does Medicare Pay for COVID-19 Booster Shots?

Like the vaccine, booster shots are provided at no charge to you by the government, regardless of your insurance status. Once the pandemic is lifted, Medicare will likely cover the additional dose of the COVID-19 vaccine at no charge to you. The COVID booster is identical to the original vaccine but serves as another layer of defense against the virus.

Beneficiaries can mix and match the vaccines, meaning they can get their booster from the same or a different manufacturer than the original two. As COVID-19 variants emerge, many are seeking additional protection from the virus.

Will Medicare Consider COVID a Pre-Existing Condition?

Some insurance companies may consider COVID a pre-existing condition when evaluating your health history. But, Original Medicare is a public health program that covers people with pre-existing conditions. So, you are free to enroll in Medicare regardless of your medical background.

The big question is: will Medicare Supplement (Medigap) carriers consider COVID a pre-existing condition? Again, it is possible. However, it will be on a case-by-case basis, depending on the carrier. Thus, it is important to sign up for a Medicare Supplement policy during your Medicare Supplement Open Enrollment Period to avoid any health-related underwriting and guarantee your spot in a Medigap plan.

How is Medicare Changing Post-COVID?

In response to the public health emergency, there was a Medicare expansion on telehealth. COVID has increased patient access to both telehealth and mental health services due to the isolation and stress that accompany COVID-19. The expansion took place to help patients receive the necessary care they require while allowing doctors to maintain recommended 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 healthcare services can now take place through telehealth.

How to Find a Medicare Plan During the Pandemic

Usually, beneficiaries choose to receive help with their Medicare coverage from a broker, in person. However, due to the pandemic, most Medicare enrollees are now going online for help. That's where we can help! Our Medicare resource center is filled with educational material to make the process as easy as possible for you.

If you're looking for a Medicare plan during this pandemic, our team of agents can help you identify a policy that meets your needs and brings you value.  Let us help you, call us at the number above to see your options. Or, fill out an online rate form to get your rates now.

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