Medicare Gets More Coronavirus Leeway

While the COVID-19 crisis worsens, Congress has made a number of important changes to Medicare to help recipients cope with associated costs, should they be tested or receive treatment.

If you are a Medicare recipient, here are the changes you should know about, thanks to the passage and enactment of the CARES Act:

No out-of-pocket testing expenses – Medicare will cover the costs of any examination to determine if you may have COVID-19, as well as any subsequent testing. Both traditional Medicare and Medicare Advantage plans are required to cover these services even if you have not met your deductible. You will not be required to cover any copays for these services either.

More and more Medicare Advantage plans, Medicare supplemental or Medigap policies, and Medicaid are also waiving all cost-sharing for COVID-19-related treatment. 

Telemedicine is available – The CARES Act has relaxed the old requirement that Medicare coverage be restricted to real-time audio-visual technology, thus opening the door to coverage for phone-based services.

The new law also relaxes the requirement that a care provider must have seen a patient in person within the past three years, and it gives the Health and Human Services secretary more leeway to relax statutory restrictions on telehealth services covered by Medicare.

These changes make telemedicine more accessible to recipients, and it’s cost-free to be examined by a certified tele-health provider. This access now extends benefits to rural areas and recipients who reside outside coverage areas and were previously excluded from using this service.

Out-of-network waivers – Medicare Advantage plans are required to cover services at out-of-network facilities that participate in Medicare, and to charge enrollees who are affected by the emergency and who receive care at out-of-network facilities no more than they would face if they had received care at an in-network facility.

All testing covered – COVID-19 testing is covered regardless of where the Medicare recipient gets it, including drive-up sites run by clinics or pharmacies. Additionally, if a telemedicine doctor prescribes the testing, the Medicare recipient will receive priority placement in line by virtue of being over 65.

This applies to all recipients, regardless of if they are enrolled in Medicare Advantage, Medicare Supplement or simply traditional Medicare.

Medicare will also cover COVID-related hospitalization and inpatient treatment. If you recover or have mild symptoms and are quarantined at home, Medicare will also cover you during the quarantine period.