Different parts of Medicare cover different aspects of COVID-19 care. However, a person may still have to pay deductibles or coinsurance.
Medicare does cover some costs of COVID-19 testing and treatment, and there is a commitment to cover vaccination.
In this article, learn what exactly Medicare covers and what to expect regarding out-of-pocket costs for COVID-19 care.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare covers the costs of testing for SARS-CoV-2, the virus responsible for COVID-19.
When a physician or another requesting healthcare provider deems the test medically necessary, Medicare Part B covers the cost, and there is usually no coinsurance or copayment required.
Various facilities can perform this testing, depending on what is available. The testing might take place at a hospital or clinic, a doctor’s office, or a drive-through site.
Medicare covers the cost, regardless of the type of testing site.
Medicare’s coverage of COVID-19 extends to both inpatient and outpatient treatment.
Doctors cannot yet treat the disease itself, but they can treat any complications, such as pneumonia.
Also, supportive care can help manage COVID-19 symptoms, and this may involve:
- oral pain relief medication
- medication to improve breathing
- intravenous fluids
Sometimes a person with COVID-19 needs inpatient care. Medicare Part A covers the cost of this hospitalization.
However, the 2021 Medicare Part A deductible is $1,484, which a person must pay before their plan covers eligible costs.
People do not need to pay a copayment for the first 60 days of inpatient treatment. A person must then pay a copayment of $371 per day, applicable between the 61st and 90th day in the hospital.
People who need to remain in the hospital under quarantine still have to pay the additional out-of-pocket expenses for the days that they spend isolated, even if they receive no treatment.
Because many appointments are no longer face-to-face, Medicare has temporarily expanded its coverage of telehealth services. These contactless services, such as virtual consultations, support self-isolation measures.
If a person sees a doctor for COVID-19 treatment, coverage comes from Medicare Part B, the part is responsible for medical costs and doctor’s consultations.
The Centers for Disease Control and Prevention (CDC) report that there is currently no authorized preventive drug for COVID-19.
Through Operation Warp Speed, the federal government aims to make 300 million vaccines available by January 2021, says the U.S. Department of Health and Human Services.
Once a Food and Drug Administration-approved vaccine becomes available, Medicare will cover the full cost of vaccinations.
It is difficult to estimate the financial costs of having COVID-19. A range of factors, such as the severity of the illness, play a role in a person’s medical expenses.
Meanwhile, the pandemic has severely impacted the employment and travel plans of many throughout the world, taking a toll on the financial outlook.
Some potential costs of having COVID-19 might involve:
According to the CDC, since September, hospitalization rates have increased among all age groups. As of mid-November, the number of hospitalized people was just under 223 per 100,000.
Typically, longer hospital stays lead to higher expenses. Also, intensive care, including the use of a ventilator or bi-level positive airway pressure machine, adds to the overall cost of treatment.
Lost wages or earnings
Various states have required nonessential or high-contact businesses to either close or reduce their hours of operation.
As a result, people receiving Medicare may lose their jobs or a portion of their wages. People in essential employment who get sick or have to self-isolate due to exposure may also lose income.
At present, Medicare does not refund lost earnings.
Each person must take steps to prevent the virus that causes COVID-19 from transmitting.
This is especially crucial for anyone in contact with older adults, who have a higher risk of COVID-19 complications than younger people.
As the CDC acknowledge, people with underlying health conditions — such as diabetes, heart disease, or chronic lung disease — also have a higher risk of these complications.
The CDC have issued the following guidelines to prevent SARS-CoV-2 from transmitting:
- Older adults and people with underlying health conditions should practice physical distancing and stay home as much as possible.
- Everyone should wash their hands frequently, especially after being out in public. It is best to use soap and warm water, and lather for at least 20 seconds.
- When soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
- Avoid touching the nose, eyes, and mouth.
- Clean and disinfect frequently touched surfaces, such as light switches, doorknobs, and faucets.
- Avoid physical contact with anyone who has symptoms.
- Clean cell phones frequently.
- Avoid touching shared public surfaces, such as handrails and door handles. When contact is necessary, protect the hand with a glove or tissue.
To prevent the spread of the virus, it is also vital to follow the recommendations and mandates of local health officials.
The COVID-19 pandemic is ongoing, but health authorities throughout the world continue to work hard to develop and deploy a safe and effective vaccine.
Medicare Part B covers coronavirus testing and some visits to a doctor, and Medicare Part A covers hospital stays for coronavirus treatment. Copayments and deductibles still apply for treatment.
Medicare is regularly monitoring its criteria and policies to respond to public health requirements.
Anyone with a Medicare Advantage plan should check with their plan provider about the most up-to-date information.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.