Medicare and COVID-19 resource-guide

After a national emergency was declared on March 13, 2020 in response to the novel Coronavirus, the Centers for Medicare and Medicaid Services (CMS) expanded the coverage and services available to all Medicare beneficiaries.

The FAQs below highlight these new services including virtual access to care, offer tips to stay healthy, and reduce stress.

This information will be updated as new services and treatments become available.

Medicare’s response to COVID-19: Frequently asked questions

What is a Coronavirus?

Coronaviruses are a family of viruses that cause illnesses that resemble the common cold or flu. In more serious cases, they can cause severe respiratory issues.

Coronaviruses are named for their spike covered surfaces which resemble the points on a crown. Corona means “crown” in Latin.

The coronavirus responsible for the pandemic is called “novel” because it is a new strain never seen before in humans. This virus is thought to have jumped from animals to humans sometime in late 2019. Because it is a newly discovered virus, it is unclear if anyone is immune to it.

What is the difference between the Novel Coronavirus, SARS-CoV-2 and COVID-19?

The “Novel Coronavirus” or “COVID-19” is the common name of the disease caused by theSars-CoV-2 virus (and is related to the SARS virus that made headlines in 2002 and 2003). While this virus shares many similar traits to the 2002 SARS virus, it’s believed to be more infectious, but less deadly than its predecessor.

How does the virus spread?

The Centers for Disease Control and Prevention states the Novel Coronavirus is spread from human to human through droplets of saliva or mucus containing the virus. Researchers believe the primary means of transmission for the disease are the droplets expelled from an infected person’s mouth during a cough or sneeze.

While not thought to be the main way of contracting the virus, researchers do believe it is possible one can get COVID-19 by touching a contaminated surface followed by touching their own mouth, nose, or possibly their eyes.

Additionally, new research has found that the virus particles can become aerosolized and are carried through moisture when someone talks or breathes. You may not think you spit when you speak, but consider breathing onto, or speaking near a mirror; the fog left behind are the actual water droplets that could transmit the virus. This is why social distancing and wearing personal protective equipment (PPE) is so important.

What are the symptoms of COVID-19?

The symptoms of COVID-19 can vary significantly from one person to the next. Some people are asymptomatic, meaning they experience no symptoms, while others may experience extreme and severe, respiratory flu-like symptoms.

According to the World Health Organization, the most common symptoms of COVID-19 include fever, fatigue, and a dry cough. Some infected people have also reported aches and pains, nasal congestion, runny nose, sore throat, and diarrhea.

If you are experiencing trouble breathing, persistent pain or pressure in your chest, confusion or inability to arouse, or bluish lips or face, seek medical attention immediately.

Is there a treatment?

At this time, there is no cure or definitive treatment for COVID-19. Doctors and scientists are currently experimenting with a range of medications that have been used to treat other conditions before the appearance of Sars-CoV-2.  

Patients with severe symptoms and respiratory distress are being treated with supplemental oxygen. In serious cases, a patient may need to be put on a ventilator. However, it’s important to keep in mind that about 80% of people recover from the disease without needing special treatment. For cases that don’t require hospitalization, self-care and treatment regimens similar to those used for flu and cold infections are recommended.

What COVID-19 testing does Medicare cover?

CMS has recently reviewed and revised its policies and has expanded coverage and offerings for all Medicare beneficiaries. As a Medicare beneficiary, you will pay nothing out-of-pocket for COVID-19 lab tests.

Will Medicare help pay for treatment and hospitalization as a result of COVID-19?

If you have to be hospitalized for COVID-19 treatment, Medicare will cover those costs, including fees for extended quarantine stays in the hospital. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. You’ll still pay for any hospital deductibles, copays, or coinsurances that apply.

As soon as a vaccine is available, Medicare will also cover the full cost under all Medicare Prescription Drug Plans (Part D). Those with Medicare Advantage plans will also receive the same benefits.

Medicare and the COVID-19 vaccine

People enrolled in Medicare Part B will receive the COVID-19 vaccine at no cost. Doses will be purchased by the government with taxpayer money, and Medicare will pay health care providers for the administration of the vaccine.  

Medicare beneficiaries can expect to gain access to the vaccine relatively quickly. The first batch of vaccinations will go to first responders and health care providers who are exposed to the virus every day, as well as seniors living in group home settings. The second phase is planned to include all older adults (over age 65), as well as individuals with underlying health conditions (no matter their age).

FDA clears a vaccine

On Dec. 11, 2020, the Food and Drug Administration authorized a vaccine created by Pfizer for distribution. As expected, they are sending the first batch to health care workers and nursing home residents. Pfizer expects to provide upwards of 25 million doses by the end of the year, and has signed an agreement with the U.S. Government to supply 100 million doses by March. Vaccines under the agreement will be free to citizens.

FDA clears second vaccine  

On Dec. 18, 2020, the Food and Drug Administration authorized a second vaccine for distribution. This should greatly increase the availability of a COVID-19 vaccine over the coming months. The second vaccine was created by Moderna and is cleared for individuals age 18 and older. This vaccine is set to follow the same distribution framework outlined by the CDC.

FDA clears third vaccine

On Feb. 27, 2021, the FDA cleared a third vaccine for distribution. The Janssen COVID-19 vaccine was created by Johnson & Johnson and is cleared for people 18 years of age or older. Unlike the others, this is a single dose vaccine. Rollout of the 3.9 million doses has already begun. Check with your local government to see if you are eligible to receive one of the COVID-19 vaccines.

What about telehealth options for Medicare recipients?

The safest place for anyone during this time is in their home with others who are also self-isolating and social distancing. While going to the doctor is still a necessity, there are other options to help keep you safe from exposure to the virus. Telehealth, or telemedicine, is one of those options.

In response to the pandemic, Medicare has expanded access to telehealth services, allowing you to stay at home while still checking in with your doctor for essential appointments.

Currently, Medicare patients may use telecommunication technology for office visits, hospital visits and other services that generally occur in-person.

The telehealth expansion includes:

  • Greater access via a variety of different devices
  • Ability to interact with different healthcare providers
  • Evaluation and management visits
  • Mental health counseling
  • Preventative screenings

These new telehealth options give you easy access to health care without risking exposure.

Steps you can take to protect yourself

The most important thing anyone can do to protect themselves from contracting the Coronavirus is to stay home and distance themselves from others. Because asymptomatic carriers are increasingly thought to be the main source of the spread, it’s smart to assume that everyone is infected — including yourself. By staying home as much as possible and keeping at least six feet away from those who don’t live with you, you’re reducing not only your chances of infection, but also reducing the chances of infecting others.

If you must leave your home, it’s a good idea to cover your nose and mouth with a cloth mask.

To stay safe:

  • Stay home as much as you can
  • Stay at least six feet away from others
  • Wash hands frequently for at least 20 seconds
  • Sneeze and cough into your elbow
  • If you’re sick, call before going to your doctor or hospital

How can I protect my mental health?

This temporary, but new way of life has been challenging for most, and increasingly stressful for seniors and those with pre-existing conditions during this crisis.

Here’s what you can do to reduce your anxiety and cope while we get through this:

  • Connect with loved ones online through social media, phone calls, or video chat
  • Try to limit the amount of news you consume per day to reduce worry and anxiety
  • Go outside for some fresh air
  • Listen to your favorite music
  • Read or watch your favorite television shows
  • Engage in a new or old hobby
  • Being kind to yourself

Overall, remember to make practical, healthy choices that will help you weather the storm. We’re all in this together.

To learn more about the the actions CMS is taking to protect Medicare beneficiaries visit:

Our mission is to inspire confidence in your health care decisions. More than ever, we are united in your Medicare journey.

While we cannot offer medical advice, we can answer your questions about Medicare coverage. Call (855) 665-9200 to speak with a licensed insurance agent today.

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