04/11/2020
What You Need to Know about Medicare and the Coronavirus
The Centers for Disease Control and Prevention (CDC) has laid out its catalogue of groups at higher risk of severe illness caused by COVID-19 (coronavirus) and overall, they correlate with those eligible for Medicare.
A list of groups considered high-risk according to the CDC includes older adults, specifically those 65 and above, who are of Medicare age. It also comprises those with chronic lung disease, moderate to severe asthma, or serious heart conditions, as well as those who are immunocompromised, or have severe obesity (body mass index of 40 or higher), diabetes, chronic kidney disease who are undergoing dialysis, or liver disease.
Although many of these groups include people of all ages, each group becomes more susceptible to severe illness caused by COVID-19 once they are of Medicare age.
Medicare Structure
To understand the services available through Medicare, you first need to understand the structure of the program itself. Medicare is divided into Parts A, B, C, and D.
Part A covers hospital stays, care in a nursing facility, and home healthcare under certain circumstances.
Part B covers medical services received from a doctor and supplies that are medically necessary to treat your health condition. These include outpatient, preventive, ambulance, and diagnostic services. Together, Parts A and B are known as Original Medicare.
Part C plans, or Advantage Plans, are offered by private insurers that contract with Medicare, and typically offer all of Part A, Part B, and in many cases Part D coverage. Part D covers prescription drug coverage, but must be purchased separately as a stand-alone policy or as part of an Advantage Plan.
Medicare Supplement Plans, also called Medigap Plans, are offered by private insurers contracted with Medicare. They cover certain healthcare costs not covered by Original Medicare, such as deductibles and copayments.
Coronavirus Coverage
To encourage those who may be showing symptoms of this pandemic to seek treatment sooner rather than later, thereby giving them the best chance of survival, most Medicare Advantage and Supplement (Medigap) Plan carriers are waiving co-pays and cost-sharing for COVID-19 inpatient hospitalizations, telemedicine, and testing through May 31, 2020.
The CDC and Medicare insurers' intentions are to improve access to COVID-19 treatment by eliminating out-of-pocket expenses for patients. However, insurance carriers may have different requirements relating to networks. Most of them allow in-network hospitalizations only, except in cases of emergency.
Testing to see if you have coronavirus is covered in full for older U.S. citizens by Medicare Part B (Medical Insurance). This test is covered when your doctor or other healthcare provider orders it. Those who are not able to leave their homes will be able to get test kits brought to them, and Medicare will pay for lab companies to collect samples in nursing homes, which house many older Americans.
It's advisable to check with your carrier and review their guidelines now, so you understand your situation just in case any services are needed.
