FAQ: How Does Your Medicare Coverage Apply to Coronavirus?

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If you are over the age of 65 or fast approaching that milestone, you have special cause to be concerned about coronavirus. According to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, the new virus (COVID-19) appears to be harder on older adults and those with suppressed immune systems or serious underlying medical conditions.

The Centers for Disease Control and Prevention has offered guidance to help protect you from infection at home as well as helpful information on how to care for yourself, including when to seek medical attention if you become sick.

But if you’re wondering how Medicare covers coronavirus, or how to make use of your coverage if you become ill, here are some quick FAQs to bring you up to speed:

Will my Medicare cover coronavirus?

Yes. Coronavirus is just like any other illness and therefore Medicare will cover it in much the same way it would cover the flu or pneumonia. Under Medicare Part B, coronavirus testing after February 4, 2020 is covered at no out-of-pocket cost to you. Most beneficaries enrolled in Medicare Advantage plans (operated by private insurers) will have access to cost-free testing as well. If you receive additional medical care for coronavirus, you may face out-of-pocket costs (copays or deductible) before your coverage kicks in, but there are no specific restrictions or limitation for coverage of coronavirus.

What if I am hospitalized or quarantined in a medical facility?

This would be covered just like any other inpatient stay in a medical facility. Specific out-of-pocket costs may apply, depending on the type of Medicare coverage you have. But medically necessary care is covered by Original Medicare and the private insurers who underwrite Medicare Advantage plans, including inpatient hospital stays.

What if I have to self-quarantine at home?

Your Medicare insurance will not pay you to stay at home or compensate you for lost income when you’re away from work. If you’re employed, talk to your employer about taking paid time off or a leave of absence if you are asked by a medical provider to self-quarantine. Some self-quarantine patients leave home to visit medical providers for tests or check-ups, and these would be covered according to the standard rules for your Medicare coverage. Medical care rendered in your own home by a licensed professional may also be covered. In some cases, Medicare offers coverage for virtual checkins and other telehealth services.

What if I want to undergo non-standard care for treatment or prevention of coronavirus?

Generally speaking, your Medicare insurance will only cover you for care that is deemed medically necessary and appropriate. Experimental or alternative forms of medicine may not be covered. If you are enrolled in Medicare Advantage, contact your health insurance company for more information about coverage of non-standard care under your plan.

Am I covered for immunization against coronavirus?

There are no available immunizations against coronavirus at this time. It remains to be seen when or if such immunizations will become available. If an immunization became broadly accepted and available, it is likely that Medicare would cover it in the same way it would any other immunization.

Whether you are carefree, cautious or panicked when it comes the coronavirus, the truth is that there is no better time to understand how your Medicare plan is working for you. Use this time to clarify your benefits when it comes to doctor visits, hospital stays, medications and preventative treatments. It’s always best to be prepared!

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