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Extended Medicare Coverage During COVID-19

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The Medicare population has been severely impacted by COVID-19. More than 900,000 people have died as a result of the virus, and 76% of them were 65 or older. Early on in the pandemic, the federal government declared a state of public health emergency in order to provide better care for the 60 million people enrolled in Medicare. The public health emergency has just been extended to April 16. 

Here’s some of the new and existing ways you can get help from Medicare during this time: 

 

Getting Covid Tests

Starting in early spring, everyone enrolled in Medicare will be able to get eight over-the-counter COVID tests each month without charge. The kits will be available at local pharmacies and other sites. 

Meanwhile, Medicare beneficiaries and all other Americans can now request four free kits for home testing at covidtests.gov. If you want to go to a facility for a free test, the link is here.

  

Going Outside Your Health Plan Network

About 40% of people on Medicare are enrolled in Medicare Advantage Plans. Under normal circumstances, you are restricted to the plan’s network of doctors and hospitals. If you go outside the network, the plan won’t pay for your care. This rule is now waived. If you go to an outside provider, your plan must pay for the care at the same rate it pays for care in the network. You will not have any additional charges. This gives people access to a much larger group of doctors and hospitals.

 

Going to the Hospital

Medicare typically only pays for a semi-private room in the hospital. However during COVID, Medicare will cover a private room when it is considered a medical necessity.  For example, if someone needs a private room to be under quarantine because of COVID, the cost of that room should be covered.

 

Going from the Hospital to a Skilled Nursing Facility (SNF)

SNFs are rehabilitation facilities where you go to recover after a hospital stay. Typically, Medicare covers care without charge for 30 days with the caveat thatyou must stay in a hospital for three consecutive days before you qualify for the coverage.

Now, according to the Federal Center for Medicare Services (CMS), this rule is waived “if you are affected by the Coronavirus public health emergency.” For example, if the hospital becomes overcrowded and patients must be moved, the move to a rehab facility would be fully covered. Or if a patient needs special rehab care because of a serious medical issue coverage would be immediate and without charge.

 

New Treatments Under Telehealth

Telehealth visits have become common since the COVID outbreak began in 2020, with patients being seen by doctors through computer visits. Historically, services were limited to certain medical professionals,but now the list has been expanded to cover telehealth treatments by Occupational Therapists and Speech Language Pathologists. Their telehealth visits will now be fully covered by Medicare.

 

Going to Visit a Loved One in a Nursing Home

The strict rules against visit have been drastically changed, with the government admitting the policy did considerable harm to nursing home residents and family members.

“While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones,” CMS said in its revised rules. “CMS understands that nursing home residents derive value from the physical, emotional and spiritual support they receive through visitation from family and friends.”

The new policy says a nursing home resident has unrestricted rights to “receive visitors of his or her choosing at a time of his or her choosing.”

Nursing homes cannot limit the frequency or length of visits, and cannot require any advance scheduling for visits.

 

Getting Medications

Medicare plans often have limits on the supply for a prescription drug. These quantity rules are suspended because of COVID. All drug plans, whether in Medicare Advantage or Part D under traditional Medicare, must now cover a 90-day supply of the medicine when the patient requests it. There are still limits in place for opioids, which can be addictive.

 

Getting the Vaccine at Home

Some people may not be able to go to a doctor’s office to get a vaccine. Medicare will pay for a doctor to come to your home to administer the shot. Contact your regular physician and request a home visit. If the doctor is unavailable, you can check the following resources: 

  • Hotline for Medicare recipients at 1-800-633-4227 (TTY 1-877-486-2048)
  • Your state health department or call 211
  • Disability Information and Access Line (DIAL) 1-888-677-1199
  • Services for older adults and their families Eldercare Locator or 1-800-677-1116

 

Bob Rosenblatt

Bob Rosenblatt has been a reporter for 40 years, specializing in aging issues, such as Medicare, Social Security, pensions, IRAs, and finding assisted living.

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