Coronavirus, Medicare, and You
What has changed?
On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 748 which in combination with Policy changes from the Centers for Medicare and Medicaid Services (CMS) includes the following critical changes to Medicare:
- Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs (Co-pays or Deductibles).
- Medicare covers all medically necessary hospitalizations. This includes if you are diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead remain under quarantine.
- As of now, there is no vaccine for COVID-19. When one becomes available, the CARES Act Section 3713 mandates vaccine coverage by Part B with no cost-sharing. Vaccines will also be covered by all Medicare Prescription Drug Plans (Part D).
- Medicare now pays for telehealth services. Check with your physician’s office to see what telehealth services they have made available.
- The federal government has reduced restrictions on advanced prescription drug refills (up to a 90-day supply) as well as restrictions on home or mail delivery of prescriptions.
- If you have a Medicare Advantage Plan, cost-sharing may be waived for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described above. Check with your plan about your coverage and costs.
This information and more can be found at www.medicare.gov/medicare-coronavirus, while you can find the complete text of the CARES Act here: www.congress.gov/116/bills/hr748/BILLS-116hr748enr.pdf
Covid-19 Medicare Resources
While some changes to Medicare are happening across the board, your specific Medicare policy carrier may have made some specific changes to their plans, benefits, and coverage.
Some markets may vary by state, so be sure to verify details specific to your state.
Beware of Medicare fraud!
Scammers may use the coronavirus national emergency to take advantage of people. Some examples:
- Robocalls offering you respiratory masks they’ll never send
- Social media posts fraudulently seeking donations for non-existent charities, or claiming to give you stimulus funds if you enter your bank account information
- Fake testing kits, cures, “immunity” pills, and offers for protective equipment
Guard your Medicare card like a credit card and check Medicare claims summary forms for errors. If someone calls you on the phone, says they are from Medicare, and asks for your Medicare number or other personal/financial information, hang up! Medicare never calls its beneficiaries to ask for or to “verify” Medicare numbers. Do not share bank account information over the phone in exchange for ‘offers’ by scammers!
If you suspect Medicare fraud, please report it by calling Medicare’s toll-free customer service center at 1-800-MEDICARE (1-800-633-4227), or by visiting www.medicare.gov/fraud.
For critical Information, follow the Medicare page dedicated to Coronavirus coverage:
For disease prevention, follow CDC Guidelines for Prevention of Virus Spread:
For Medicare Coverage and Payment Updates:
For more on Medicare Advantage and Part D Prescription Drug Plan flexibility:
For more about Telehealth services and relaxed standards for use:
For more on what actions your State is taking:
www.ncsl.org/research/health/state-action-on-coronavirus-covid-19.aspx and www.nga.org/coronavirus/#actions
For more on Your Medicare Rights during the Corona Crisis:
For help enrolling in Medicare, as well as comparing and/or buying existing Medicare Policies in your service area, call us at the Medicare Comparison helpline (866-391-7763) to speak to a licensed agent who is specially trained to help you understand your Medicare options, or request assistance here: medicarecompareusa.com/speak-with-an-agent
While many newly eligible beneficiaries can usually enroll in Medicare at their local SSA Office, social distancing guidelines during the coronavirus national emergency have led to the temporary closure of SSA offices for in-person services. However, the SSA is still available for enrollment assistance by phone and online.
By Phone – Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778). Due to high usage enrollees should anticipate long wait times for enrollment via phone.
Online – Apply for Medicare at www.ssa.gov/benefits/medicare The whole process should take less than 30 minutes, although the online application is only available during the following hours (all times Eastern time):
Monday-Friday: 5 a.m. until 1 a.m.
Saturday: 5 a.m. until 11 p.m.
Sunday: 8 a.m. until 10 p.m.
Holidays: 5 a.m. until 11 p.m.
For more information on how to apply online, you can read this SSA publication: www.ssa.gov/pubs/EN-05-10530.pdf
People who worked past age 65 and delayed Medicare enrollment because they had health insurance through their employers now need to sign up for Medicare Part B during their Special Enrollment Period (8 months from the loss of employer coverage). If you have not signed up for Part A already, you will need to sign up for that as well, but you should expect late enrollment fees. If you are turning 65 within the next 3 months, you can sign up for Medicare now as part of you Initial Enrollment Period.
If you will not turn 65 for several (6+) more months you can:
Medicare will pay for nursing home testing (assuming tests are available in your service area) thanks to relaxed federal health system restrictions. Contact your personal care provider or healthcare provider about whether you are a qualified candidate for the Coronavirus specimen test.
Medicare patients admitted for treatment at a hospital for treatment are still subject to the 2020 Medicare Part A deductible of $1,408. Part A requires daily copays for any extended inpatient hospital and skilled nursing facility stay. Beneficiaries would pay a $352 copayment per day for stays extending to 61-90 day, and $704 per day for lifetime reserve days. If a patient must remain quarantined even though they would otherwise be discharged, they will not be required to pay any additional deductible for hospital stays. If a beneficiary needs post-acute care after hospitalization, they will need to pay $176 per day for extended days in a SNF (days 21-100). For COVID-19 treatment-related outpatient services covered under Part B, the 2020 $198 deductible still applies, as well as coinsurance for most services. Cost-sharing conditions for beneficiaries in Medicare Advantage plans may vary.
According to the Coronavirus Preparedness and Response Supplemental Appropriations Act (and as amended by the CARES Act) the HHS Secretary has waived certain restrictions on Medicare coverage of telehealth services for Medicare beneficiaries effective March 6, 2020, including allowing:
- Beneficiaries in any geographic area to receive telehealth services
- Beneficiaries to remain in-home for telehealth visits reimbursed by Medicare
- Telehealth visits to be delivered via smartphone with real-time audio/video interactive capabilities
- Telehealth services for beneficiaries who have not received these services in the last three years
- Federally qualified health centers and rural health clinics to provide telehealth services
- Telehealth services unrelated to COVID-19 including regular office visits, mental health counseling, and preventive health screenings.
- “Virtual Check Ins” with no originating site requirement
Original Medicare covers a telehealth services under Part B, so beneficiaries are subject to the 2020 Part B $198 deductible and 20 percent coinsurance. During the COVID-19 public health emergency, providers have been given the flexibility to reduce or waive cost sharing for telehealth visits.
Medicare Advantage plans may offer additional telehealth benefits not covered by Original Medicare, Medicare Advantage carriers also have the flexibility to waive certain requirements with regard to coverage and cost sharing during the COVID-19 public health emergency as long as they do so in a uniform manner for all similar beneficiaries.
For more FAQs, read what CMS has provided here: www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf