FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

More than 60 million people ages 65 and older and younger adults with long-term disabilities are covered by Medicare. Due to their older age and higher likelihood of having serious medical conditions than younger adults, virtually all Medicare beneficiaries are at greater risk of becoming seriously ill if they are infected with the new coronavirus that causes COVID-19. COVID-19 is an infectious respiratory disease, which currently has no vaccine or cure. Diagnosis of COVID-19 is confirmed through testing, and treatment varies based on the severity of illness.

These FAQs review current policies for Medicare coverage and costs associated with testing and treatment for COVID-19, including changes adopted in three recent bills: the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, enacted on March 6, 2020 (Public Law 116-123); the Families First Coronavirus Response Act, enacted on March 18, 2020 (Public Law 116-127); and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020 (Public Law 116-136).  Click here to learn more. 

Medicare Beneficiaries Without Supplemental Coverage Are at Risk for Out-of-Pocket Costs Relating to COVID-19 Treatment

The coronavirus outbreak has heightened concerns about out-of-pocket health care costs and the ability to pay for COVID-19 treatment. This is of particular concern for older adults who are at higher risk of getting seriously ill from the coronavirus and may require hospitalization. The Trump Administration recently announced that the uninsured will not have to pay any hospital costs for COVID-19 treatment, and many insurers are voluntarily waiving cost sharing for treatment, including firms that cover a majority of Medicare Advantage enrollees. Other Medicare beneficiaries may also have some or all of their COVID-19 treatment costs covered by supplemental coverage, such as Medicaid, employer-based insurance, or Medigap.

However, a significant number of Medicare beneficiaries – nearly 6 million adults 65 and older and younger adults with long-term disabilities – do not have any supplemental coverage and therefore could be hit with a large hospital bill if they are admitted for COVID-19. Nearly 4 in 10 (39%) have incomes less than $20,000 a year, nearly 3 in 10 (29%) are in fair or poor health, and 15% are age 85 or older (Figure 1). Close to 10% of these beneficiaries live in long-term care facilities, such as nursing homes, which CMS has recognized as particularly susceptible to infections.  Click here to learn more.