Those on Medicare are the most vulnerable to COVID. Coverage for this group of people is perhaps the most important. Whether it’s COVID testing, treatment, or vaccines, we have the information on Medicare you need to get through this pandemic.
Medicare Coverage for COVID-19 Testing
Medicare Part B will cover COVID-19 testing ordered by a health professional and done in a laboratory, pharmacy, doctor’s office, or hospital. You’re allowed one test annually without a doctor’s order, at no additional cost. Since Part C plans must cover at least as good as Medicare, these plans will also cover testing.
Coverage is also available for serology tests which can determine if a person has been infected with the virus and developed antibodies.
Medicare Coverage for Drive-thru COVID Testing
Medicare will cover COVID tests in some “parking lot” testing sites. Before arrival, you can contact the testing site to confirm they will accept your insurance.
Medicare Coverage for at-Home COVID Testing
On Feb. 2, 2022, Medicare announced it would cover up to 8 at-home tests per month for its beneficiaries. These will be available at any retailer or pharmacy that chooses to participate.
This setup means Medicare pays the retailer or pharmacy directly to disperse these tests, and there aren’t any out-of-pocket costs for Medicare recipients.
Furthermore, community health centers and Medicare-certified health clinics may offer free at-home tests for those with Medicare.
Although it’s not a Medicare-specific benefit, every household in America is currently entitled to receive 4 free at-home COVID tests sent straight to their door by the U.S. Postal Service. The website to sign up for this is covidtests.gov.
Those with a Part C policy may have coverage for an at-home or over-the-counter COVID test, but you’ll need to contact your plan to see if it covers these tests.
Medicare Coverage for Free Covid Tests by Mail
You’ll receive coverage if your online pharmacy offers covid tests by mail and accepts Medicare.
FAQs
Does Medicare Cover COVID Testing for Travel?
Medicare will cover pre-travel COVID testing at no additional cost, but you may need to use a facility that accepts Medicare. Before you arrive, you can confirm with the facility if they will accept Medicare.
Does Medicare Cover Rapid COVID Testing?
Americans can order four rapid COVID tests online at covidtests.gov. The test is free and will ship out in 7-12 days. These rapid tests give results within 30 minutes and don’t require a lab drop-off.
The site only allows households to order four tests. Beyond these four tests, you may need to go to a testing site for a free test.
How Much Does COVID Testing Cost for Medicare Beneficiaries?
Typically, Part B services have an applicable deductible and coinsurance. However, beneficiaries that get the COVID test aren’t paid because clinical diagnostic laboratory tests have coverage under Medicare with no cost-sharing.
Prior authorization is prohibited from being implemented for testing. Testing services such as the associated physician or outpatient visit won’t result in cost-sharing for you.
Does Medicare Cover Treatment for COVID in the hospital?
Medicare will cover treatment costs relating to COVID. If you require hospitalization, you’ll still be responsible for the cost of the Part A deductible, coinsurance, and any applicable copayments.
Medigap insurance can help cover the cost of Part A or Part B coinsurances that Medicare would otherwise leave you responsible for paying.
If you have a Medicare Advantage plan, you’ll need to look at your evidence of coverage to determine your inpatient costs. Each policy is different.
Will Medicare Cover Monoclonal Infusions?
Medicare will cover the monoclonal antibody infusions when they take place in an outpatient setting, and they’re used to treat mild to moderate COVID.
Does Medicare cover Paxlovid oral covid treatment?
Paxlovid is currently not approved by the FDA and is considered experimental. Since it’s not approved by the FDA, it’s not covered by Medicare at this time.
Does Medicare Cover the COVID-19 Vaccine?
Yes, Medicare will cover the COVID-19 vaccine. You won’t pay anything for the first or second shot. Medicare will cover the Pfizer, Moderna, or Johnson & Johnson COVID vaccines. You won’t pay a deductible or copayment for the shot, and your doctor can’t charge you an administration fee.
Also, you’ll need to bring a red, white, and blue Medicare card so the healthcare provider can bill Medicare; you won’t need a Medicare Advantage plan card. You may be able to get your COVID vaccine in your home.
Will Medicare Cover the COVID Vaccine Booster?
Yes, Medicare will cover the COVID-19 vaccine booster shot. You can get the booster from the same COVID-19 vaccine or choose a different one. Either way, you’ll pay nothing.
How Can I Get Help Covering Costs for Treating COVID
If you get COVID and need treatment, a Medigap plan can be beneficial. The 20% coinsurance can add up quickly.
Give a Medicare expert a call today to see which options are available to you and find the plan that makes the most sense. Or, fill out an online rate form to see the plans in your area now.
