During the outbreak of COVID-19, Medicare is supporting people by providing coverage for the healthcare they need. The SARS-CoV-2 antibody test is included in this coverage.
The coronavirus antibody test determines if a person has developed an immune response to the viral infection, SARS-CoV-2.
While many services covered by Medicare involve out-of-pocket costs, the antibody test is free of charge.
This article describes Medicare coverage of the antibody test. Then, it examines coverage of other healthcare for COVID-19 and the associated out-of-pocket costs.
Lastly, it discusses COVID-19 symptoms and the increasing availability of testing, as well as listing reliable sources of additional information.
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.
Original Medicare includes Part A, which covers inpatient care, and Part B, covering outpatient services.
Part B covers the SARS-CoV-2 antibody test, sometimes called the serology test, which may show if a person has had the virus in the past.
Medicare Advantage, also known as Medicare Part C, provides the same coverage as original Medicare parts A and B, including the antibody test.
Once someone develops SARS-CoV-2, their body makes antibodies against the virus that causes the disease within 1–3 weeks. Because of the time required to make antibodies, the test may not show a current infection.
If the test finds antibodies are present, it indicates a person may have some protection against reinfection.
At this time, doctors do not know how much immunity the antibodies provide or how long the protection lasts.
Individuals do not have to pay any out-of-pocket costs for the test, whether they have original Medicare or Medicare Advantage.
Testing is an essential part of the effort to contain COVID-19.
To deal with challenges associated with testing, the National Institutes of Health have invested millions of dollars in technologies that may substantially increase the type and number of available tests by as soon as
As the United States government is endeavoring to increase testing availability, it has also relaxed Medicare rules to make it easier for people to get access to the tests.
Medicare is now allowing more testing in community-based settings as well as at home.
Medicare covers medically necessary hospitalizations for COVID-19, which would include any treatment a person receives during a hospital stay. Medicare Part A and Medicare Advantage cover these costs, and deductibles and other out-of-pocket expenses may apply.
In addition to the SARS-CoV-2 antibody test, which may show a past infection, Part B and Medicare Advantage cover lab tests that may indicate a current infection. Coverage is also available for a vaccine, once one becomes available.
Some individuals with original Medicare have a Medigap policy, which is Medicare supplement insurance. These plans cover 50–100% of parts A and B out-of-pocket costs. The coverage would include any healthcare costs related to COVID-19.
Medicare Part D covers outpatient prescription drugs and is available to those with original Medicare. It is also included in some Medicare Advantage plans. To this date, the Food and Drug Administration (FDA) have not approved any outpatient drugs that treat COVID-19.
Both original Medicare and Medicare Advantage have out-of-pocket costs.
Part A costs
Hospitalization costs include:
- $1,408 deductible for each benefit period
- $0 copayment for days 1–60 of each benefit period
- $352 copayment per day for days 61–90 of each benefit period
- $704 copayment per day for each lifetime reserve day of each benefit period
A benefit period starts the day a person enters a hospital as an inpatient and ends the day after they have been home from the hospital for 60 days.
Once someone has been in a hospital for 90 days, Medicare provides coverage of an additional 60 days, known as lifetime reserve days.
Part B costs
Part B covers the entire cost of any tests used to diagnose COVID-19.
According to the Kaiser Family Foundation, Medicare will also cover the entire cost of a vaccine once the FDA approves its safety and effectiveness.
Private insurance companies administer Medicare Advantage plans, and therefore, out-of-pocket costs relating to COVID-19 are different under these plans from those of original Medicare.
Because people with a Medicare Advantage plan pay Part B premiums, they receive complete coverage of COVID-19 tests. They will also receive a vaccine free of charge when one becomes available.
The virus SARS-CoV-2 can cause the condition or disease that is known as COVID-19.
- shortness of breath
- fever or chills
- sore throat
- muscles aches
- loss of taste or smell
A person may need emergency medical treatment if they have any of the following symptoms:
- trouble breathing
- sudden confusion
- persistent pain or pressure in the chest
- bluish lips or face
- inability to stay awake
During the COVID-19 outbreak, people may need sources for sound advice. To avoid misleading information, a person can consult reliable medical and government websites, such as:
Medicare covers the SARS-CoV-2 antibody test and other tests a doctor needs to diagnose this and COVID-19.
The antibody test may indicate a person has had the virus in the past, while the other tests may show whether they currently have it. All people with Medicare may get the tests free of charge.
COVID-19 coverage also includes hospitalization. The out-of-pocket costs of original Medicare and Medicare Advantage may differ.
Once a vaccine becomes available, Medicare will cover the full cost.