Last Updated: 3/2/2021
Below is a guide to help Medicare beneficiaries stay informed and better protect themselves against the novel coronavirus (COVID-19), including how Medicare coverage can help.
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Original Medicare (Medicare Part A and Part B) and some private Medicare Advantage (Medicare Part C) plan carriers are responding to the pandemic in a number of ways.
Additionally, some Medicare Advantage plan carriers are also offering benefits such as:
Check with your Medicare Advantage plan carrier to find out what benefits are currently available to you.
Medicare does cover telehealth services related to COVID-19. In fact, the Centers for Medicare & Medicaid Services (CMS) has actually expanded Medicare coverage of telemedicine services due to the outbreak.
Health care providers can conduct video consultations with patients who are experiencing symptoms consistent with COVID-19. This allows seniors to remain in the safety of their home while receiving care, as opposed to risking the contraction or spread of the infection by visiting a doctor’s office.
When COVID-19 was declared a national emergency, the rules for refilling certain prescription medications were loosened.
Medicare Part D plans and Medicare Advantage plans that include prescription drug coverage are now allowed to relax their “refill-too-soon” restrictions. This allows beneficiaries to stock up on an extended supply of their medications.
Because the COVID-19 outbreak was declared a national emergency, Medicare Advantage and Medicare Part D beneficiaries are able to receive qualified care outside of their plan’s network, if their Part D plan or Medicare Advantage plan includes a network of providers.
During the period of declared emergency, Medicare Advantage plans are required to cover services at out-of-network facilities that participate in Medicare and charge the beneficiary a rate that is no more than what they would have paid at an in-network facility.
Part D plans must also ensure members have adequate access to covered medications at out-of-network pharmacies when the use of an in-network facility cannot be reasonably expected.
Part D plans are also given freedom to relax rules about mail-delivered medications.
There are currently 2 authorized COVID-19 vaccines in the U.S. People who are already infected with the virus can be treated for the symptoms it causes.
Any treatment administered for the symptoms of COVID-19 will be covered in the same way those services and items are already covered by Medicare. Medicare also covers the COVID-19 vaccine for all beneficiaries.
The treatment methods being used to address the symptoms of COVID-19 include:
Medications used to treat a fever may be covered by a Medicare Part D prescription drug plan or a Medicare Advantage plan that includes prescription drug benefits.
Supplemental oxygen is typically covered by Medicare Part B. Medicare Part A covers inpatient hospital stays, while outpatient visits are covered by Part B.
If you are admitted for inpatient hospital care, your Medicare Part A deductible applies. The Part A deductible is $1,484 per benefit period in 2021.
If you receive medical care for symptoms of COVID-19, you’re typically responsible for 20 percent of the Medicare-approved amount for covered services after you meet your Part B deductible. In 2021, the Part B deductible is $203 per year.
Yes, Medicare covers the COVID-19 vaccine.
The 2 federally authorized coronavirus vaccines are the Pfizer-BioNTech vaccine and the Moderna vaccine. Other companies are continuing to work on developing additional vaccines.
Yes. Due to the novel coronavirus outbreak, the CMS has implemented the following Medicare nursing home guidelines:
Nursing homes are also taking extra steps as recommended by the Centers for Disease Control and Prevention (CDC), including stocking extra soap and sanitizer and making face masks, disinfectant and personal protective equipment readily available.
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Coronaviruses are a large family of viruses that cause anything from the common cold to more severe diseases like Severe Acute Respiratory Syndrome, or SARS.
Novel coronavirus is a new strain that has not been previously identified in humans. This strain leads to a disease called COVID-19.
Coronaviruses are zoonotic, meaning they are transmitted to humans from animals.
For example, SARS was initially transmitted from a cat, and MERS (Middle East Respiratory Syndrome) was first transmitted to humans from a camel.
It is not yet known which animal may have been the source for the newest strain of coronavirus, but it first surfaced in the Chinese city of Wuhan (which has a population of over 11 million people) in December.
Once coronavirus is transmitted to humans, it spreads from person to person through respiratory droplets that are coughed, sneezed or exhaled into the air by the infected person and inhaled by another. These droplets can be inhaled by anyone within approximately six feet of an infected person.
Coronavirus can also live on surfaces such as door handles or tables and be spread by touching your mouth or nose after coming into contact with the infected surface.
It is estimated that each infected person will infect on average 2-3 additional people.
Older adults and those with underlying medical conditions such as diabetes, high blood pressure, cardiovascular disease, respiratory disease and cancer are most at risk.
A study in China showed that the average age to develop acute respiratory distress syndrome –or severe shortness of breath that requires the use of a ventilator – as a result of coronavirus is 61 years old.1
Older adults may also be at a higher risk of being exposed to the coronavirus. Millions of seniors reside in senior living communities, assisted living homes or nursing homes, putting them in close contact with other seniors.
Many of the first-reported COVID-19 deaths in the U.S. have been traced to a nursing home in Seattle, Washington.
Children appear to be at less of a risk. One study from the China Center for Disease Control and Prevention (CCDC) found that just 2% of coronavirus cases affected children under 18 years old, and of those, only around 3% developed a severe case of COVID-19.2
Coronavirus infection symptoms typically appear 2-14 days after exposure to coronavirus and include:
COVID-19 may also bring persistent pain or pressure in the chest and a bluish discoloration in the lips or face.
More severe cases can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
The mortality rate for COVID-19 has been estimated at around 2.2%, though that number may not represent the exact lethality of the disease, as not all cases of infection are reported.3
Some people who have tested positive for the coronavirus have shown only mild symptoms or no symptoms at all.
There is no current treatment for the coronavirus or COVID-19 itself. Infected persons are treated for their symptoms, such as taking steps to alleviate their fever and suppress their cough.
Supportive care such as oxygen therapy and fluid management can also be effective treatment for symptoms.
Coronavirus testing has been made free for people in the United States who have health insurance.
There are a few different ways to test for COVID-19.
Only certain facilities have been approved for coronavirus testing. If your health care provider thinks you should be tested for coronavirus, they will contact the Centers for Disease Control (CDC) and refer you to a facility approved for testing.
Coverage of the test is protected as an essential health benefit as dictated by the Affordable Care Act.
The coronavirus test is covered by Medicare Part B, and you will pay nothing out-of-pocket for it if you are a Medicare beneficiary.
There are currently 2 federally approved and recommended vaccines for COVID-19:
There have been up to nine companies in the U.S. actively working toward the development of vaccines throughout 2020 and 2021, some of which are being backed by government funding.
Medicare covers the coronavirus vaccine for all qualified beneficiaries.
There are a number of things seniors can do to reduce their risk of exposure to the coronavirus.
Face masks may help prevent the spread of the coronavirus from infected people. However, they are not believed to reduce the odds of contracting the coronavirus.
As of March 2, 2021, the novel coronavirus (COVID-19) has infected 28,456,860 Americans, resulting in 513,122 total deaths.4
Refer to the list below to stay up to date on the latest news related to COVID-19, the current coronavirus pandemic and what you may need to know as a Medicare beneficiary.
Be sure to check back in with this list so that you don't miss important updates.
Medicare telehealth and telemedicine benefits are now permanent. Medicare temporarily covered telehealth when the COVID-19 pandemic struck, but Medicare will now cover telehealth even after the coronavirus outbreak has subsided.
Learn more about how Medicare covers telehealth
The Centers for Medicare & Medicaid Services is calling on nursing homes to double down on COVID-19 safety protocols during the holiday season.
Learn more about Medicare nursing home guidelines during the holidays
Almost half of U.S. hospitals will reductions in Medicare payments in 2021 because of their readmission rates. These financial penalties come during an already hard time for hospitals reeling from the coronavirus (COVID-19) pandemic.
Learn more about these Medicare penalties
An updated White House ruling confirms Medicare will cover an eventual COVID-19 vaccine. This new policy closes a lingering loophole as to whether Medicare could cover the coronavirus vaccine.
Read more about the latest vaccine rules from Medicare
Labs that return COVID-19 test results in two days or less will receive a higher reimbursement amount from Medicare than labs that give slower results.
Learn what Medicare is doing to increase testing speed
Nearly 6 out of 10 Americans believe Medicare and private health insurance should bear more responsibility for covering the cost of long-term care. 56% say Medicare specifically should pay more.
Read more about the new survey
A recent study shows private employers are increasingly in favor of government intervention into health insurance, including Medicare expansion and drug price regulation.
Learn more about the new research
Seniors on Medicare may receive $200 gift cards for prescription drugs as part of President Trump’s America First Healthcare Plan.
Learn more about Trump's prescription drug cards
COVID-19 has made nursing homes a more dangerous place for older Americans. Some additional funding for a key Medicaid program aims to help.
Learn more about COVID-19 nursing home regulations
Data from the CMS projects Medicare Advantage premiums to drop in 2021 while plan selection and enrollment continue to increase.
Learn more about 2021 Medicare plan premiums
Considerably more Medicare Advantage (Part C) plans will offer supplemental benefits for in-home care services in 2021 than ever before.
Learn more about 2021 Medicare plans and home health care benefits
A recent report highlights how much money Medicare saves when surgeries are performed at an ambulatory surgical center instead of a hospital outpatient facility. Future savings are expected to grow.
Learn more about projected Medicare savings
The repayment of more than $100 billion worth of Medicare loans handed out to hospitals as part of COVID-19 relief efforts may be extended and relaxed as part of recent legislation.
The CARES Act states that if a vaccine for COVID-19 becomes available, it will be covered by Medicare. But a technicality potentially stands in the way of that happening.
Learn more about this potential coverage issue
Medicare has issued a message to hospitals: Report your COVID-19 data or risk losing your Medicare reimbursement payments.
Learn more about Medicare requirements for hospitals during COVID-19
The Centers for Medicare & Medicaid Services updated their guidelines for nursing home visitation including outdoor visits and clarified definitions of compassionate care for indoor visits during COVID-19.
Learn about new Medicare guidance for nursing home visits
Nursing homes have been granted a 2.2% Medicare pay raise for fiscal year 2021.
Learn more about how Medicare funding for skilled nursing facilities will change in 2021
The federal government granted $100 billion in Medicare loans to hospitals to keep them afloat during the COVID-19 crisis. Those hospitals are now asking for forgiveness of the loans.
Read about the impact COVID-19 is having on Medicare funding
The White House issued an executive order in an attempt to lower Medicare drug costs. The order forces drug makers to use foreign drug pricing as a benchmark for how drugs are priced in the U.S.
Find out how Medicare drug costs may decrease in 2021
A new Medicare proposal incentivizes the development of innovative home dialysis machines in hopes of allowing more beneficiaries with ESRD to receive treatment from home.
Learn more about the new Medicare proposal
A second coronavirus relief package – the proposed HEALS Act – may contain some provisions that impact Medicare.
Learn more about how you may be affected
COVID-19 has disrupted the health insurance coverage of many older adults. Here are the answers to some common insurance questions facing older adults in 2020.
Learn about your insurance options during COVID-19
Face mask have become part of our everyday wardrobe during the coronavirus (COVID-19) pandemic. It's especially important for older adults to select the right mask, wear it correctly and wash it regularly.
Read our guide to face masks to learn how to shop for, wear and wash your mask
Remdesivir has been used to successfully treat some patients with severe symptoms of COVID-19. The Chairman and CEO of Gilead Sciences recently commented on the costs Medicare beneficiaries and people with private insurance will face for remdesivir treatment.
Learn more about the costs of remdesivir
Black Medicare beneficiaries are hospitalized for COVID-19 almost four times as frequently as Caucasian beneficiaries, and Hispanic Americans enrolled in Medicare are more than twice as likely as Caucasians to be hospitalized for the disease.
Learn about the latest research on racial disparities in COVID-19 outcomes
The coronavirus (COVID-19) outbreak may have disrupted Medicare enrollment for some beneficiaries, so the Centers for Medicare & Medicaid Services (CMS) has issued a pair of Special Enrollment Periods.
Learn about these enrollment periods and the actions you may take
Different types of Medicare coverage can help pay for COVID-19 treatment in different ways.
Learn more about your Medicare coverage options for COVID-19 costs
Certain pre-existing conditions can increase the risk for serious health complications as a result of COVID-19.
Learn how Medicare can help treat and screen for pre-existing conditions
The COVID-19 pandemic has forced many people into isolation. Some Medicare beneficiaries may have at-home options for things like mail-order prescription drugs.
Learn more about at-home Medicare benefits
If you lose employer health insurance during the COVID-19 outbreak, and if you didn’t enroll in Medicare at age 65 because you were still covered by your employer’s health insurance plan, you may qualify for a Special Enrollment Period.
Learn more about Medicare Special Enrollment Periods
All of the Social Security offices in the U.S. are now closed because of the COVID-19 pandemic. This may have many people wondering how their enrollment or current benefits may be affected, or how they can get answers to their Social Security and Medicare questions.
Learn how you can get Social Security and Medicare help during the outbreak
The federal government will issue stimulus checks to millions of Americans to help keep the economy afloat during the COVID-19 outbreak.
Read answers to some common questions many older adults may have about the stimulus money
Several private Medicare plan providers, including Cigna, Humana and Aetna, have taken measures to reduce or eliminate out-of-pocket costs (such as copays and deductibles) for plan beneficiaries who undergo treatment for COVID-19.
Learn more about how some insurance carriers are waiving certain costs during the outbreak
The Coronavirus Aid, Relief and Economic Security (CARES) Act economic stimulus package is set to make a sizable impact on the health care industry in America.
Learn about how the CARES Act specifically affects Medicare payments
The Centers for Medicare & Medicaid Services (CMS) has approved the Medicaid waiver requests of 29 states under section 1135 of the Social Security Act in response to the COVID-19 outbreak.
Learn about how these waivers help states combat the pandemic
The COVID-19 pandemic has the potential to inflate Medicare spending by up to $115 billion over the next year, according to a recent study released by the National Association of Accountable Care Organizations.
Learn more about the potential effect that COVID-19 may have on Medicare spending
Medicare completed an inspection of the nursing home in Kirkland, WA, that was the epicenter of the novel coronavirus outbreak in America.
Read about Medicare’s findings and new inspection guidelines for nursing homes
Medicare is easing the burden being faced by doctors during the coronavirus (COVID-19) outbreak by extending the deadline for quality reporting measures.
The deadline for reporting results has been extended in order to allow doctors on the front lines of the outbreak to focus on patient care.
Read more about what these Medicare guidelines mean for you
Some Medicare beneficiaries and other seniors are currently being targeted by scams such as the selling of fake COVID-19 tests and vaccines.
Learn about some of these scams and how you can protect yourself
The Centers for Medicare & Medicaid Services (CMS) has urged hospitals to delay nonessential surgeries to free up staff and resources for the wave of COVID-19 patients.
Read more about the official Medicare recommendations
The Centers for Medicare & Medicaid Services will expand telemedicine services coverage nationwide in an effort to help seniors receive medical attention from the safety of their own homes and to help curb the spread of the novel coronavirus (COVID-19).
Learn about how seniors can utilize telemedicine in the wake of these changes
Medicare is taking steps to keep nursing home residents safe amid the COVID-19 outbreak. Because nursing home residents are older and in close proximity to other older adults, nursing homes have become a dangerous breeding ground for the virus.
Read about what Medicare is doing to keep residents safe
Declaring the outbreak of COVID-19 a national emergency opened some doors for Medicare to take more aggressive steps in its fight against the pandemic.
Learn what a declaration of emergency means for Medicare beneficiaries
Medicare recently released details about how COVID-19 testing would be reimbursed to health care providers administering the tests.
Learn what these reimbursement amounts are and how they differ according to the type of test
In the wake of the novel coronavirus pandemic, the CMS released guidance on how Medicare Advantage and Medicare Part D prescription drug plans can properly respond to the outbreak.
Read more about Medicare updates for private plans
Vice President Mike Pence announced during a March 4 press briefing that the test for COVID-19 will be covered by Medicare and Medicaid, in addition to private insurance.
Schumer called for Medicare to cover the vaccine when one does become available, saying at a press conference that his plan to have Medicare fully cover the cost of the vaccine “will mean no senior will be forced to make the choice between shelling out and going without.”
Learn more about Medicare and potential vaccine coverage
Below are some resources for updated news, information and tips about the coronavirus and COVID-19 that may be helpful to seniors:
1 Yanli Liu, et al. (Feb. 27, 2020). Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. medRxiv. https://doi.org/10.1101/2020.02.17.20024166.
2 The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020[J]. China CDC Weekly, 2020, 2(8): 113-122.
3 Worldometer. COVID-19 Coronavirus Outbreak. Retrieved February 1 from www.worldometers.info/coronavirus.
4 Center for Disease Control and Prevention (CDC). (March 2, 2021). Coronavirus Disease 2019 (COVID-19) in the U.S. Retrieved March 2 from www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
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