In general, Medicare and Medicare Advantage plans cover COVID-19 tests, treatments and vaccines.
The United States enters the second year of the coronavirus epidemic. It has already conducted more than 360,000,000 COVID-19 tests and is continuing to distribute millions of vaccines. According to a Kaiser Family Foundation report, about one in six people 65 years and older tried to register for vaccines but failed. About 4 out of 10 older adults who were able to get vaccinated successfully or attempted to sign up for the vaccine said it was difficult.
For the 61 million Americans insured through Medicare and Medicare Advantage plans, vaccines and tests for COVID-19 fall under their Medicare coverage, but details can be hard to pin down. The Centers for Medicare and Medicaid Services (or CMS) has modified Medicare rules to address COVID-19 needs since the outbreak. Here’s a quick rundown:
Does Medicare cover COVID-19 testing?
Yes, Medicare Part B (medical insurance) covers all costs for tests to see whether you have COVID-19. A doctor’s order is not required. You are covered for any tests that you receive from a hospital, pharmacy, doctor, or laboratory. In some cases, a trained medical assistant, lab technician, or home health nurse may be able administer tests to you at your home. A Medicare Advantage plan must cover all the same benefits as Medicare Part A and Part B.
This coverage includes:
- COVID-19 testing to help or diagnose.
- Taken together with the COVID-19 test, these tests can be used to diagnose COVID-19.
- Parking lot testing.
Medicare Part B will cover COVID-19 antibody testing authorized by the Food and Drug Administration if you have been diagnosed with COVID-19. These tests are also known as serology tests and can be used to determine if you have an immune reaction to COVID-19.
Medicare Advantage and Medicare cover all costs of COVID-19 and COVID-19 antibodies tests.
Does Medicare cover COVID-19 treatment costs?
Yes, Medicare will cover a wide range of COVID-19 treatment costs. Medicare will pay for monoclonal antibodies treatments. This is where people with mild or moderate symptoms who have been tested positive for COVID-19 are given antibodies in a laboratory.
Medicare will cover hospitalizations due to COVID-19. This includes days you are not normally discharged from inpatient treatment but must remain in the hospital to quarantine. You will be responsible for all hospital deductibles, copays, and coinsurance.
In 2021, for instance, if you have Original Medicare, you’ll pay a Part A deductible of $1,484 before coverage kicks in for the first 60 days of a hospital stay, unless you have supplemental insurance (or Medigap) that covers your deductible. Your deductible, copays, and coinsurance for Medicare Advantage will differ by plan.
Is the COVID-19 vaccine covered by Medicare?
Yes. Medicare covers all vaccine costs for COVID-19. There is no deductible, copay, or administration fee. You must have your Medicare card and/or Medicare number, even if you are enrolled in a Medicare Advantage program. This will allow the pharmacy or medical provider to bill Medicare. If you have Medicare Part A and need to fill out a form for the vaccine, please leave any “group numbers” fields blank or write “N/A.”
Medicare Advantage plans must provide the same benefits as Medicare Part A or Part B. They may also offer additional benefits. Please check your plan for specific details.
For more information about vaccines in your region, please contact your state’s health department or go to its website. The VaccineFinder from the Centers for Disease Control and Prevention has a drop-down list of states and territories that will send you to the correct site.
For questions regarding Original Medicare coverage and costs, call Medicare at 800-633-4222 or visit Medicare.gov.