Medicare Coverage During the Coronavirus Public Health Emergency

Medicare covers medically necessary items and services related to coronavirus when you receive care from a provider who accepts Original Medicare or is in-network for your Medicare Advantage Plan. Medicare has also changed certain coverage requirements in response to the current coronavirus public health emergency.

Note: Medicare Advantage Plans must cover everything that Original Medicare does, but they can do so with different costs and restrictions. Additionally, Medicare Advantage and Part D plans must meet certain requirements following the declaration of a public health emergency.

Coronavirus testing

Coronavirus testing is covered under Medicare Part B. Your doctor can bill Medicare for tests provided after February 4, 2020. Medicare covers your first coronavirus test without an order from a doctor other qualified health care provider. After your first test, Medicare requires you to get an order from your provider for any further coronavirus tests you receive.

Original Medicare covers coronavirus testing and associated provider visits at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover coronavirus testing without applying deductibles, copayments, or coinsurance when you see an in-network provider.

COVID-19 vaccine

A COVID-19 vaccine has been authorized for limited emergency use. This emergency authorization means that the vaccine is only available for certain groups of people, such as nursing home residents and health care workers. The vaccine is not yet approved for or available to everyone. Speak with your doctor to learn more about your eligibility to receive the vaccine and its availability in your state.  

Original Medicare Part B covers the vaccine, regardless of whether you have Original Medicare or a Medicare Advantage Plan. You will owe no cost-sharing (deductibles, copayments, or coinsurance).  Click here to learn more.

What You Need to Know About COVID-19 and Flu

Every winter is a bit of a roulette wheel when it comes to influenza. Flu vaccines work, but aren’t 100% effective in preventing disease, so it’s always a challenge convincing people to get their flu shots. And while the symptoms are generally bearable, infections can become more severe and even deadly among people who are older or who have underlying health conditions.  Last flu season, even though experts considered it a relatively mild year, about 400,000 people in the U.S. were hospitalized and 22,000 people died from the flu.

This winter, the influenza virus has a rival—the coronavirus fueling the COVID-19 pandemic—and health officials are anticipating a showdown that could have dire consequences for the health of millions. Both diseases are caused by viruses that spread with abandon from person to person through sneezes, coughs, and respiratory droplets during close contact. But while researchers know quite a bit about the influenza virus, the coronavirus, SARS-CoV-2, is very much a black box, and they can only guess what will happen when the two pathogens collide throughout the world.  Click here to learn more. 

What you'll pay for Medicare in 2021

QUESTION: I know there will be a small cost-of-living increase in Social Security benefits next year, but what about Medicare? What will the Medicare Part B monthly premiums be in 2021, and when do the surcharges kick in for higher income beneficiaries?

ANSWER: The Centers for Medicare and Medicaid Services recently announced its cost adjustments for 2021, and the increases for premiums and out-of-pocket costs for most beneficiaries will be modest. But if you’re a high earner, you’ll pay more. Here’s what you can expect starting in January.

Medicare Part B

While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services, does have a monthly premium. Starting in 2021, the standard monthly Part B premium will be $148.50, up from $144.60 in 2020. That $3.90 bump represents a 2.7% increase, which is more than double the most recent Social Security cost-of-living adjustment, which was 1.3%.  Click here to learn more.