COVID-19 Related Medicare Benefits Update for Medicare Beneficiaries

Update: April, 2020

For more current updates visit the official US Government Medicare website: https://www.medicare.gov/medicare-coronavirus

Retraction of recent SEP opportunity communication 

On March 30, we received additional feedback from the Centers for Medicare & Medicaid Services (CMS) about special election period (SEP) messaging related to COVID-19. As a result , we are retracting our recent communication titled “SEP opportunity may be available to Medicare beneficiaries impacted by the COVID-19 major disaster.” 

Telehealth Services Approved

Medicare has temporarily expanded its coverage of telehealth services to respond to the current Public Health Emergency. These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). Check with https://www.medicare.gov/medicare-coronavirus for more details.

COVID-19 Related Benefits

  • Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs.
  • Medicare covers all medically necessary hospitalizations. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine.
  • At this time, there’s no vaccine for COVID-19. However, if one becomes available, it will be covered by all Medicare Prescription Drug Plans (Part D).
  • If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described below. Check with your plan about your coverage and costs

Medicare’s Additional Steps

  • Taking aggressive actions and exercising regulatory flexibilities to help healthcare providers and Medicare health plans.
  • As part of an effort to address the urgent need to increase capacity to care for patients, hospitals can now provide hospital services in other healthcare facilities and sites that aren’t currently considered part of a healthcare facility. This includes off-site screenings.
  • Waiving certain requirements for skilled nursing facility care.
  • Establishing new codes to allow providers to correctly bill for services related to diagnosis and treatment of the illness.
  • Instructing our national network of State Survey Agencies and Accrediting Organizations to focus all their efforts on infection prevention and other cases of abuse and neglect in nursing homes and hospitals.
  • Instructing nursing homes and hospitals to review their infection control procedures, which they’re required to maintain at all times.
  • Issuing important guidance answering questions that nursing homes may have with respect to addressing cases of COVID-19.

Don’t be scammed:

Scammers may use the coronavirus national emergency to take advantage of people while they’re distracted. As always, guard your Medicare card like a credit card, check Medicare claims summary forms for errors, and if someone calls asking for your Medicare number, hang up!