Medicare Coverage for COVID-19

Mar 20, 2020 / Amanda Chase, Horsesmouth Assistant Editor

As the number of cases of COVID-19 (also called coronavirus) increases, so does the importance of programs like Medicare in helping older adults, people with disabilities, and their families build and maintain their health and economic security. Accordingly, policymakers are taking critical steps to ensure program preparedness, keep beneficiaries and the public informed, and facilitate timely access to appropriate care. The Centers for Medicare & Medicaid Services (CMS) is working to address the spread of the disease and inform people with Medicare about the services that Medicare covers.

In general, Medicare covers medically necessary items and services that a beneficiary receives from a provider who accepts Original Medicare or is in-network for the beneficiary’s Medicare Advantage Plan. Medicare Advantage Plans must cover everything that Original Medicare does, but they can do so with different costs and restrictions. Medicare-covered services related to coronavirus include:

  • Coronavirus testing
  • Coronavirus vaccine
  • Prescription refills
  • Inpatient hospital care
  • Outpatient hospital care
  • Skilled nursing facility (SNF) care
  • Physicians’ services in the home
  • Telehealth services

Medicare Advantage Plans and Part D plans usually have networks of providers and pharmacies that beneficiaries must use in order to receive covered services at the lowest cost. During emergencies, Medicare Advantage Plans must work to maintain access to health care services and prescription drugs for plan members living in affected areas. Plans must meet certain requirements following the declaration of a disaster, emergency, or public health emergency. For example, Medicare Advantage Plans must charge in-network cost-sharing amounts for services received out of network.

Click here to find more details and updates on what is covered at the Medicare Rights Blog.

 

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