What you need to know about Medicare and COVID-19

Public health policy and healthcare recommendations about COVID-19 continue to evolve three years after the pandemic first broke in 2020.

 

In May 2023, the Department of Health and Human Services (HHS) announced the official end of the public health emergency posed by COVID-19. This means coverage for vaccinations and COVID-19 care is shifting as well.

Medicare and COVID-19 Highlights

  • As of 2023, free at-home COVID tests will no longer be available.
  • Coverage will vary from state-to-state for state Medicaid programs and ends September 30, 2024
  • With the end of the public health emergency, private insurers no longer have to cover the cost of COVID-19 tests
  • Seniors who have a disability or have other health challenges may have the choice to receive the vaccine at home and at no cost
    • Medicare continues to cover vaccines without cost sharing
    • You might have cost sharing for COVID-19 diagnostic tests
    • Medicare doesn't cover over-the-counter (OTC) tests.
    • Telehealth services continue through December 31, 2024.

 

Does Medicare cover COVID testing?

Original Medicare and Medicare Advantage plans both cover COVID-19 treatments to varying degrees. Also, the type of service or test depends on the circumstances and the plan. Here’s a general coverage overview.

 

  • Medicare Part B covers PCR and rapid COVID-19 There is no cost to you if you get this test from a doctor, pharmacy, laboratory, or hospital. You do not need an order from a healthcare provider.
  • Lab tests -Part B covers COVID-19 diagnostic tests without cost sharing when ordered by a health care provider and done by a laboratory.
  • Oral antivirals – You may be covered under Medicare Part D if you are at high risk of getting very sick from COVID-19.    
  • Serology tests - Medicare Part B covers antibody (serology) testing if you were diagnosed with COVID-19.
  • Medicare B covers Monoclonal antibody treatments for COVID-19
  • Original Medicare does cover the costs of COVID-19 vaccines. There is no deductible, copayment or administration fee 

More Medicare resources

Here are more resources that can help answer questions or provide guidance about Medicare and COVID-19. Be sure to check with your own state as rules do vary from state to state.

 

1-800-Medicare

 

www.medicare/gov/medicare-coronavirus

 

State Health Insurance Assistance Program (SHIPS) www.shiphelp.org  or call 877-839-2675

Content contained on this page is for informational purposes only and does not constitute medical advice. Consult your health care provider before beginning any new fitness or dietary plan. References provided are for informational purposes only and do not constitute endorsement of any websites or other sources. Should you have any health-related questions, you should contact your health care provider.

 

Sources: