Will Covid-19 Treatment be Covered by Medicare?

People with specific health conditions are at a higher risk for developing serious complications from COVID-19. Most seniors have at least one underlying health condition. This is why most seniors who test positive for COVID-19 require a more aggressive treatment plan than their younger counterparts. However, that’s not to say younger people with the same health conditions aren’t at the same risk level.

Certain underlying health conditions that put people at a higher risk for serious complications from COVID-19 include but aren’t limited to cancer, chronic obstructive pulmonary disease, obesity, and heart disease.

Fortunately, the COVID-19 test is covered at 100% by Medicare. Your treatment, however, will be covered under normal Medicare rules. COVID-19 treatment varies by person, but it’s best to learn how Medicare covers various treatment types so you’re prepared if you were to need it.

Methods of COVID-19 treatment

At this time, there is no treatment for COVID-19 that suits everyone. Treatment for COVID-19 generally involves a lot of rest, fluids, and waiting. Your treatment will depend on your specific circumstances and symptoms.

For example, if you’re overall healthy and aren’t experiencing severe symptoms, your doctor may recommend you quarantine at home as part of your treatment. However, if you have underlying health conditions and are having trouble breathing, your doctor may advise you to be admitted to the hospital as an inpatient.

In-home quarantine COVID-19 treatment

If you’re able to quarantine at home, Medicare will cover your telemedicine doctor visits. Telemedicine is a way to communicate with your healthcare provider via two-way voice and video. Before the coronavirus pandemic, Medicare only covered these types of visits for some beneficiaries who met specific circumstances.

However, now, and even after the pandemic, Medicare will cover a telemedicine doctor visit like a normal appointment for all beneficiaries. Therefore, Medicare Part B will cover the visit at 80% after the Part B deductible, leaving you with a 20% coinsurance. However, many providers are waiting Medicare cost-sharing on telemedicine services during the pandemic.

Hospitalization COVID-19 treatment

If you require hospitalization following a positive COVID-19 test, Medicare will cover your stay and medically necessary services during your stay. You will be subject to your typical Part A and Part B cost-sharing expenses. However, if you have a Medigap plan that covers those for you, you may not experience any bills from your hospitalization.

Medicare Part A covers your room and meals provided during your stay, among other things, while Part B covers your doctor-provided services. Your Part A deductible will cover up to 60 days in the hospital. You pay the full deductible whether you’re an inpatient for 10 days or 60 days. In 2020, the Part A deductible is $1,408.

Your Part B services provided to you during your stay will also be subject to the Part B deductible and 20% coinsurance. Therefore, for a 14-day stay, you could be responsible for the Part A deductible, Part B deductible, and Part B 20% coinsurance. But if you have a comprehensive Medigap plan such as Plan G, you’d only be responsible for the Part B deductible.

Prescription drug treatment

Currently, there isn’t a drug regimen that treats COVID-19. However, your doctor may prescribe certain medications to treat your symptoms. Medicare Part D covers your prescription medications. If you’re an inpatient in the hospital, Part A covers your medications.

If you have a Medigap plan, you should also have a stand-alone Part D plan for drug coverage. However, if you have a Medicare Advantage plan, your Part D coverage is likely built into your plan.

Your costs and covered drugs will depend on the plan you’re enrolled in. You’ll pay a certain copay or coinsurance for each specific drug tier. For example, your tier one drug may have a $5 copay, whereas your tier three drug may have a $47 copay. If your plan doesn’t cover your drug, you will pay the full price for your prescription. You can see a list of covered drugs on your plan’s formulary.

Therefore, other than your COVID-19 test, which is covered at 100%, your medically necessary services to treat COVID-19 are all covered by Medicare and are subject to your normal Medicare cost-sharing expenses. If you are diagnosed with COVID-19, you can rest assured knowing Medicare has you covered.