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What You Need to Know About COVID-19 and Medicare

We will continue to provide updates to keep you informed on COVID-19 and Medicare. If you have questions about your Medicare coverage and the coronavirus, contact a licensed GoHealth insurance agent for guidance and additional resources.

Key Takeaways

  • Medicare covers all lab tests and antibody tests for COVID-19.
  • Be skeptical of COVID-19 fraud, and if you ever suspect fraud, make sure to report it.
  • Always use trusted sources when gathering any information regarding COVID-19.

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For most people age 65 and older, Medicare covers hospital visits and/or medically necessaryHealthcare services that are necessary for the diagnosis or treatment of an illness, injury, condition, disease or symptoms. resources. That means that older Americans have a range of ways to prevent infection and, if they do catch COVID-19, there are several Medicare-approved therapeutic options to help treat it. Below are the most critical tips around what you need to know about COVID-19 and Medicare.

The Importance of COVID-19 Vaccination

  • Long-term care facility residents can receive COVID-19 vaccinations.
  • All COVID-19 vaccine tests included clinical trial participation by tens of thousands of people to ensure they meet safety standards and protect adults of different races, ethnicities, and ages, including adults over the age of 65.
  • The Centers for Disease Control and Prevention (CDC) work with pharmacies and other partners to provide communication materials to educate patients about the vaccine and answer their questions about vaccine safety and other issues.

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Where and When to Receive Coronavirus Testing

Before diving into the details of COVID-19 testing, it’s essential to recognize the symptoms associated with the virus. These can include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle/body aches, headache, loss of taste or smell, sore throat, congestion, nausea or vomiting, and diarrhea. It’s also possible to have COVID-19 but be asymptomatic, meaning you are not showing any symptoms.

You should consider a test if:

  • You are experiencing any of the above symptoms.
  • You are in close contact with someone showing COVID-19 symptoms or with a positive diagnosis.
  • You have been asked or referred to get tested by your healthcare provider or a local or state health department.
Medicare covers lab tests for COVID-19 and FDA-authorized COVID-19 antibody tests. If you do get tested, you should self-quarantine/isolate at home pending test results and follow your healthcare provider’s advice.

To determine where you should get a test, visit your state or local health department’s website to look for the latest information on local testing that is currently available. If you have questions regarding whether or not you should receive a COVID-19 test and where you can receive a test in your area, please contact your doctor.

What Do I Need to Know About a Coronavirus Vaccine?

Receiving a COVID-19 vaccine may help protect you from contracting COVID-19.  Experts believe that getting a COVID-19 vaccine may keep you from getting seriously ill even if you contract the virus, which is good news for older adults and those who are immunocompromised. The CDC keeps the public updated as new types of COVID-19 vaccines and clinical data about their effectiveness becomes available.

How to Avoid Fraudulent Coronavirus Messages

Unfortunately, there are COVID-19-related scams that attempt to steal personal details. Scammers target older adults and those with severe long-term health conditions. They use telemarketing calls, text messages, social media messages, and door-to-door visits to obtain information and cause harm. These scammers may offer COVID-19 tests, money, or Medicare prescription cards, or even pretend to be a COVID-19 contact tracer to get access to your details.

With the rise in these fraudulent messages, it’s critical to protect yourself. It’s important to know that you will never be asked for money to be more eligible to receive a vaccine and that Medicare will not call beneficiaries to offer COVID-19 related products, services, or benefit reviews. Always be skeptical of any unexpected calls or visitors providing anything about COVID-19 – and if you get a call like this, hang up. If you make an appointment for a COVID-19 test online, make sure that the location is a legitimate testing site.

If you ever suspect a COVID-19 fraudulent scheme, report it on the HHS.gov site or call 800-HHS-TIPS (800-447-8477).

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Inpatient and Outpatient Hospital Care — What’s Covered?

If you become seriously ill due to COVID-19, you may need to rely on inpatient or outpatient services. Medicare Part A covers inpatient hospital stays, skilled nursing facility stays, some home health visits, and hospice care. Medicare Part B covers outpatient services (including physician visits, emergency ambulance transportation, and emergency room visits).

Medicare beneficiaries (including those under traditional Medicare and Medicare Advantage plans) are covered if they require inpatient hospitalization for COVID-19 treatment. Beneficiaries get coverage for skilled nursing facility stays, but not for long-term services and support, such as more extended stays in a nursing home. For any questions regarding your coverage, please contact one of our licensed agents at 1-855-792-0088.

When and How to Use Telehealth

Telehealth use has rapidly increased since the beginning of the pandemic. Your doctor may suggest connecting with them via a telehealth appointment, rather than having you visit the office in-person and risk exposure. Telehealth has served as a great tool to expand access to care because it reduces potential disease exposure to staff and patients, preserves personal protective equipment supplies, and reduces demand for facilities.

In response to the pandemic, Medicare temporarily expanded its coverage of telehealth services through the end of 2024. For specifics on how to access your provider’s telehealth platform, please contact your doctor’s office.

Use Trusted Resources to Learn More

Information regarding COVID-19 is evolving, and it’s essential to stay up to date by using trusted resources to receive information. Sources such as the CDC, your state’s department of health, the World Health Organization (WHO), and the National Institutes of Health (NIH) are a few reliable sources that can be trusted. In addition to these resources, you can always contact your healthcare provider for updates and guidance.

For Medicare-related questions regarding COVID-19, please don’t hesitate to reach out to one of the licensed GoHealth insurance agents for personal guidance at 1-855-792-0088.

FAQs

Yes, lab tests for COVID-19 are covered under Medicare Part B. Medicare does not cover over-the-counter tests.
Patients who get seriously ill from the virus may need a variety of inpatient and outpatient services. Medicare Part A covers:
  • Inpatient hospital stays
  • Skilled nursing facility (SNF) stays
  • Some home health visits
  • Hospice care
If inpatient hospitalization is required for treatment of COVID-19, this treatment will be covered for Medicare beneficiaries, including those in Original Medicare and Medicare Advantage plans.
Based on a provision in the CARES Act, a vaccine approved for COVID-19 will be covered by Medicare under Part B with no cost-sharing; this applies to beneficiaries in both Original Medicare and Medicare Advantage plans.

Sources

This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.

Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.