Medicare and the Coronavirus

The latest on free testing, telehealth, elective surgeries and more.

Will Medicare pay for a coronavirus test?

• Yes. Medicare will pay for you to get a test for COVID-19, and you won't have to pay anything out of pocket. Under the already enacted Families First Coronavirus Response Act, deductibles and copays for people on Original Medicare and who have Medicare Advantage plans will be waived for medical services related to testing, such as going to the doctor or hospital emergency room to see if they need to be tested.

What if I can’t get out to get a test?

• Medicare will allow your doctor to order a test be brought to your home and administered there. And you still won’t have to pay anything for it.

I’m in a nursing home. How will I get tested?

• Laboratory officials are now being allowed to go to nursing homes and collect samples from residents, which Medicare officials believe will lead to more vulnerable Americans being tested for the virus.
  

What if I contract COVID-19 and have to be hospitalized?

• If you have Original Medicare and you must be hospitalized because of the Coronavirus, you will still have to pay the Medicare Part A deductible, which is $1,408 per hospital visit for 2020. For those who have additional coverage, this deductible is covered by most Medigap plans. The deductibles and copays for hospital stays for people enrolled in Medicare Advantage plans vary by plan. If you would normally be ready to be discharged from the hospital but have to remain under quarantine because you have COVID-19, you won't be charged extra for being kept in a private room and won't have to pay an additional deductible.

How would the new Coronavirus Aid, Relief and Economic Security (CARES) Act help Medicare beneficiaries?

• The Cares Act will help Medicare Part D enrollees by requiring the plans to offer up to 90-day prescription refills. It will also make it easier for Medicare beneficiaries to get home health services, by allowing advanced practice nurses and physician assistants to order such care.
• Hospitals that treat Medicare beneficiaries for the coronavirus would get a 20 percent increase in their payments for those services, including inpatient stays. Further, the measure would ensure that Medicare enrollees and older Americans who have private insurance would have access to any vaccines available to prevent infection from the virus.

Can I still apply for Medicare during the outbreak?

• Yes, but only online. If you are turning 65 or are under 65 and have a disability, you can still go to ssa.gov and apply for Medicare. While the Centers for Medicare and Medicaid Services (CMS) operates the program, the Social Security Administration handles Medicare enrollment. The SSA will continue to process applications. The wrinkle:
• SSA field offices have been closed temporarily because of the pandemic, and the hotline is handling only critical issues, not including new Medicare applicants — thus the need to apply online.
• If you are 65 or older and have lost your job and health insurance or were on your spouse's health insurance and she or he lost a job and health coverage, you can go to the SSA website and apply for Medicare by asking for a Special Enrollment Period (SEP).
• Normally, if you are applying for Medicare Part B as part of the SEP, your employer or your spouse’s employer would have to attest that you had health coverage within the past eight months. Because of the pandemic, federal officials have waived that requirement and are allowing applicants to fill out that form themselves and submit proof that they’ve had health coverage.
• SSA officials say they realize some beneficiaries may have difficulty mailing in the forms and employment proof to apply for Part B. So, you can now fax or upload both the Medicare Part B form, CMS-40B and CMS L564- Request for Employment Information, along with proof that you had health coverage through your job to 1-833-914-2016.
• If you apply in April for Medicare Part B because you’ve lost your employment-based coverage, your Part B coverage will be effective in May.

Is the Medicare hotline still open for questions?

• Yes. If you have questions about your coverage or the services that are covered or have other issues, the 800-MEDICARE hotline is open 24 hours a day, seven days a week.

Medicare is recommending telehealth visits. What devices can I use, and how do I access a telehealth consultation?

• The best way to schedule a telehealth visit is to call your doctor or other health care provider. During the pandemic, regulations for telehealth have been relaxed, so patients can get a telehealth consultation from their homes and providers and their patients can use their phones, tablets, computers and other devices. Providers are also able to waive deductibles and copays for these appointments.
• I was scheduled for a knee replacement. My spouse was supposed to have cataract surgery soon. Can we still have these procedures?
• It depends. CMS has appealed to doctors and their patients to postpone elective surgeries and other procedures while the coronavirus outbreak is straining hospital resources nationwide. Under the CMS guidelines, you would be asked to consider postponing your knee surgery, based on whether your condition could be life-threatening in the future. Your spouse would be asked to postpone cataract surgery.
• The guidelines make clear that nonelective, non-coronavirus-related care, such as transplants, cardiac procedures for patients with symptoms, cancer procedures and neurosurgery, would still be provided.

I'm on Medicaid. Will I still be able to get my benefits?

• Medicaid is a federal-state partnership that serves low-income Americans of all ages, children and pregnant women. Each state operates its own Medicaid program, with the federal government providing funding, overall rules and guidelines.
• During the pandemic federal officials have offered to relax certain requirements, such as some nursing home preadmission reviews and the ability of providers to deliver care in alternative settings if, say, a nursing home needs to close and residents must be moved to an alternate site.
• States are also being allowed to temporarily modify Medicaid eligibility and benefit requirements, to enable older beneficiaries and individuals with disabilities to be cared for in their homes, including allowing states to remove restrictions on Medicaid's paying for telehealth visits.