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Covid Medicare Coverage

What we know about the Coronavirus is that seniors are at a higher risk of serious illness than younger age groups.  So how has Medicare, the primary health insurance program for Americans over 65, responded?

                Medicare will cover the cost of a Coronavirus test under Part B.  Additionally, co-pays and deductibles have been waived as well as the costs associated with the test, such as a doctor’s visit or hospital observation.  If and when a vaccine becomes available that too will be covered.

                If you need treatment for Covid-19, hospitalization is covered under Part A and outpatient services are covered under Part B.  This is no different than treatment for any other injury or illness.  Under normal rules if you are hospitalized for a minimum of 3 days and then discharged to a skilled nursing facility for rehabilitation, Medicare will cover as much as 100 days, although for days 21 through 100  there is a co-pay of $176 per day. (Many Medigap policies cover the co-pay.)  Now, however, the 3 day hospital stay has been relaxed.  If the hospital needs to transfer you to make room for new patients, you can get subacute coverage in a nursing facility under Medicare even if you have not met the 3 day requirement.

                Medicare has expanded its telehealth coverage during the current pandemic so that seniors can get coverage under Part B.  This applies whether the reason for the telehealth visit is related to Covid or not.  The definition of telehealth has also been expanded.  Previously, telehealth calls needed to be done from a health facility that has video conferencing technology such as an outpatient center.  Now Medicare will cover it if the call originates from the patient’s home via video using digital devices such as a laptop, desktop, smartphone or tablet.  The rule about telehealth visits only with a doctor who saw you in the past 3 years is also temporarily suspended.                 There has been discussion about further changes as the crisis continues although the talk has been from Medicare advocates with no indication at this point that the federal government will entertain further changes.  One suggestion of note is to waive the 24 month waiting period for Medicare coverage that younger Americans with disabilities face when they first qualify for Social Security Disability benefits. But, again, this is coming from advocates and there has been no comment from government officials.