Does Medicare Cover COVID?

One woman’s hospital bill for coronavirus treatment came to more than $1.3 million, according to the Los Angeles Times. Medical care in the U.S. isn’t cheap. In addition to worrying about the virus itself, you may be worried about health insurance coverage for COVID-19. If you have Medicare insurance, you may be wondering – does Medicare cover COVID?

The good news is that Medicare covers COVID. Many coronavirus-related services may be provided with no out-of-pocket costs. Other services may be subject to some costs, including copays and deductibles.

Here’s how Medicare covers COVID-19. 

Medicare Coverage for COVID-19 Testing

If you suspect that you have COVID-19, you may want to be tested. The good news is that Medicare covers COVID-19 testing. 

Medicare says that it pays for lab tests for COVID-19, and that beneficiaries pay no out-of-pocket costs. In Original Medicare, the costs are covered when the test is obtained through a laboratory, pharmacy, doctor, or hospital. Additionally, Medicare Advantage plans cannot charge copayments, deductibles, or coinsurance for lab tests to diagnose COVID-19. 

Medicare may also cover FDA-authorized COVID-19 antibody testing.

Medicare Coverage for COVID-19 Treatment 

Some cases of COVID-19 are mild and can be treated at home. Other cases are more severe and may require medical care. 

All necessary hospitalizations are covered under Medicare. According to Medicare, this coverage will include hospital stays when the beneficiary would have been discharged after an inpatient stay but is required to stay in the hospital for quarantine.

However, this doesn’t mean you won’t pay anything. If you require hospitalization, you will be responsible for your hospital deductibles, copays, and coinsurance. 

Medicare Coverage for COVID-19 Vaccines

Medicare provides coverage for FDA-approved COVID-19 vaccines. 

The FDA has authorized the Pfizer-BioNTech and Moderna COVID-19 vaccines for emergency use. Due to the limited supply of available vaccines, eligibility for vaccination is determined by state health departments. 

To find out if you are eligible to be vaccinated and where you can receive a vaccine, use the CDC tool to find information from your state health department.  

In Original Medicare, the vaccine is covered under Medicare Part B with no out-of-pocket costs. Beneficiaries who have Medicare Part A only will pay nothing for the vaccine itself, but they may be charged a fee for administration of the vaccine. Beneficiaries who are enrolled in Medicare Advantage should pay nothing for the vaccine.

When you get your vaccine, make sure you bring your Medicare card. If you are required to fill out a form with insurance information and you are enrolled in Medicare Part B, you can put “N/A” in the section that asks for the insurer’s group number.  

Medicare Coverage of Telehealth

Many people want to avoid going to a doctor’s office or clinic because they are worried about being exposed to coronavirus. However, this does not mean you should delay care. You may be able to receive care without leaving your home. 

Medicare has expanded its telehealth options in response to the coronavirus pandemic. This coverage includes virtual check-ins and the use of online patient portals. If you would like to take advantage of telehealth services, talk to your healthcare provider. You may be responsible for your usual copays and deductibles. 

Many Medicare Advantage plans offer telehealth benefits that go beyond Original Medicare’s coverage. See your plan’s details for more information on telehealth coverage.

If you think you have COVID-19, stay home except to get medical care. Call your doctor before going into the office or clinic for testing or treatment. If you have trouble breathing or other symptoms that indicate a medical emergency, get emergency medical care immediately. See the CDC page on what to do if you are sick for more information on symptoms and safety.  

COVID-19 and Special Enrollment Periods

If you need to enroll in Medicare, you may qualify for a Special Enrollment Period.

Most people enroll in Medicare for the first time during the Initial Enrollment Period when they turn 65. Enrollment can also occur during the General Enrollment Period, which occurs between January 1 and March 31 every year. However, enrolling during the General Enrollment Period may lead to coverage delays and late enrollment penalties. Current Medicare enrollees have an opportunity to change their plan selection each year during the Annual Election Period, also called the Open Enrollment Period, which lasts from October 15 to December 7.

However, if you have lost your job and your employer-based health insurance, you may qualify for a Special Enrollment Period.  

Other Out-of-Pocket Costs

Even when Medicare covers tests, vaccines, and other services related to COVID-19 with no out-of-pocket costs, there may be a charge for other services. For example, you may need to pay a copay for a doctor’s visit. If you have questions about your coverage and costs, contact your provider and insurance plan for information. 

Watch out for COVID-19 and Medicare Scams

Scammers have been taking advantage of the fears and confusion surrounding the COVID-19 pandemic. Be on guard against scammers trying to steal your Medicare information or your money.

Scammers may pretend to be from the FDA, CMS, the CDC, Medicare, the state health department, the WHO or other official organizations. Scammers may also spoof the phone numbers and email addresses of these organizations. If you receive a phone call, text message or email from someone claiming to be with one of these organizations, it may be a scam. Do not give out your Medicare information or provide payment.

CMS says that you CANNOT pay to put your name on a list to get the COVID-19 vaccine and you CANNOT pay to get early access to the vaccine. If someone is requesting money for early access to the vaccine, they are trying to scam you. 

If you want to receive the COVID-19 vaccine, use the to navigate to the correct information from your state health department.  

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