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Coronavirus and Medicare: What You Need to Know

Floating viruses

Is Coronavirus Covered by Medicare?

Key Takeaways:

  • SARS-CoV-2 is a new coronavirus that causes the COVID-19 illness.
  • Medicare covers FDA-authorized COVID-19 vaccines and related lab tests, antibody tests, monoclonal antibody treatments, medically necessary hospitalizations, and expanded telehealth services.
  • However, many of the standard Medicare deductibles and coinsurance amounts apply when it comes to extended stays in the hospital or a skilled nursing facility.
  • Some scammers may try to convince you that you need to pay for the COVID-19 vaccine or to get on a list to access the vaccine or that you should hand over your personal or financial information. Make sure that you don’t give in to their demands!

What’s the Difference Between Coronavirus and COVID-19?

The Details About SARS-CoV-2

Did you know there are many types of coronaviruses? The newest coronavirus, named SARS-CoV-2, is the one that’s currently causing a global pandemic of respiratory illness, which is called COVID-19. 

According to Johns Hopkins Medicine, the virus quickly spreads between individuals “through droplets and virus particles released into the air when an infected person breathes, talks, laughs, sings, coughs, or sneezes.” Once it enters the body, WebMD explains:

“The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs.

Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells.”

COVID-19 Symptoms and Prevention

Once the process is complete, you might experience symptoms like fever, a cough, shortness of breath, fatigue, chills, body aches, and headache. You might also experience congestion, loss of taste or smell, and nausea and vomiting.

All of this is why wearing masks, washing hands, applying alcohol-based hand sanitizer, and physically distancing yourself from others effectively prevent the spread of COVID-19. Another effective prevention mechanism is vaccines, which have been authorized for emergency use by the U.S. Food and Drug Administration.

With these details in mind, will your Medicare insurance cover Coronavirus vaccines?

Does Medicare Cover the Coronavirus Vaccine?

Medicare covers FDA-authorized COVID-19 vaccines, which have been shown to be safe and effective, at no cost to you. Just be sure to bring your Medicare card with you. 

In fact, Medicare will pay a doctor or other care provider to visit you in the comfort of your own home and administer the vaccine if you have a disability or face other challenges in getting to a vaccination location. They’ll also cover:

  • Lab tests
  • FDA-authorized COVID-19 antibody (or “serology”) tests, but only if you were diagnosed with COVID-19
  • Monoclonal antibody treatments
  • Medically necessary hospitalizations, less any hospital deductibles, copays, or coinsurances that apply (more soon)
  • Expanded telehealth services
  • Medicare Part B (Medical Insurance) also covers a test to see if you have coronavirus

According to the Medicare.gov website:

“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 and expanded benefits, like meal delivery or medical transport services. Check with your plan about your coverage and costs.”

Watch Out for Coronavirus-Related Scams

Although you’ll have no out-of-pocket expenses when receiving the COVID-19 vaccine, some scammers might attempt to convince you otherwise. 

They’ll also try to get you to disclose your personal or financial information or convince you to hand over your hard-earned money to put your name on a list to get the vaccine. Or to gain access to the vaccine in the first place. Don’t give in to their demands!

Outside of the above no-cost treatments, will you have to pay for other COVID-19-related medical expenditures?

How Much Will Medicare Pay for Other COVID-19 Treatments?

If you’re admitted to the hospital for COVID-19 treatment, you’ll pay the $1,484 Medicare Part A deductible (as of 2021). If you remain hospitalized for between 61 and 90 days, you’ll also pay a $371 per-day copayment, which increases to $742 after 90 days. However, if you’re quarantined in the hospital, you won’t have to pay an additional deductible.

If you need post-acute care in a skilled nursing facility (SNF) following a hospitalization, you’ll pay a $176 per-day copayment. Along these same lines, outpatient services are subject to a $203 deductible and 20 percent coinsurance for services like physician visits and emergency ambulance transportation.

Now that we’ve covered all of the essential details, do you have any questions you need to be answered?

Would You Like to Know More About How Medicare Responds to Different Medical Concerns?

At IHS Insurance Group, our specialty is answering complex questions in a down-to-earth, easily understandable way. That’s why we’ve been helping clients like you with their Medicare needs for more than a decade.

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Also, check out our Medicare FAQs here.