Posted in Awareness

Medicare and Covid19 Testing and Hospitalization

Coronavirus test

Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called 2019-novel coronavirus or COVID-19). This test is covered when your doctor or other health care provider orders it.

Your costs in Original Medicare

You pay nothing for this test.

What it is

Tests done to help your doctor diagnose or rule out a suspected illness or condition.  In some circumstances, a home health nurse, laboratory technician, or an appropriately-trained medical assistant may give you this test in your home. 

Things to know

Medicare also covers preventive tests and screenings to help prevent, find, or manage a medical problem.

Related resources

Center for Disease Control’s response to the coronavirus

Inpatient hospital care

Medicare Part A (Hospital Insurance) covers inpatient hospital care when all of these are true:

  • You’re admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
  • The hospital accepts Medicare.
  • In certain cases, the Utilization Review Committee of the hospital approves your stay while you’re in the hospital.

Your costs in Original Medicare

Note

See how Medicare is responding to Coronavirus.

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

What it is

Medicare-covered hospital services include:

  • Semi-private rooms
  • Meals
  • General nursing
  • Drugs as part of your inpatient treatment
  • Other hospital services and supplies

Things to know

Inpatient mental health care in a psychiatric hospital is limited to 190 days in a lifetime.

Inpatient hospital care includes care you get in:

  • Acute care hospitals
  • Critical access hospitals
  • Inpatient rehabilitation facilities
  • Long-term care hospitals
  • Inpatient care as part of a qualifying clinical research study
  • Mental health care

Medicare Part B (Medical Insurance)

covers your doctors’ services you get while you’re in a hospital.

This doesn’t include:

  • Private-duty nursing
  • Private room (unless medically necessary )
  • Television and phone in your room (if there’s a separate charge for these items)
  • Personal care items, like razors or slipper socks

Medicare & Coronavirus

How to stay up to date:

  • Coronavirus.gov is the source for the latest information about COVID-19 prevention, symptoms, and answers to common questions. 
  • CDC.gov/coronavirus has the latest public health and safety information from CDC and for the overarching medical and health provider community on COVID-19.
  • USA.gov has the latest information about what the U.S. Government is doing in response to COVID-19.

Medicare wants to help protect you from COVID-19:

Your health, safety, and welfare in the face of the 2019 Novel Coronavirus (COVID-19) is our highest priority. According to the Centers for Disease Control and Prevention (CDC), older adults and people who have severe chronic medical conditions like heart, lung, or kidney disease seem to be at higher risk for more serious COVID-19 illness.  This means that most people with Medicare are at higher risk.

Follow the President’s Coronavirus Guidelines for America

Visit Whitehouse.gov for the full set of guidelines. Here are some critical ways for you to do your part:

  • Listen to and follow the directions of your state and local authorities.
  • Keep the entire household at home if someone in your household has tested positive for coronavirus. 
  • If you’re an older person or if you’re a person with a serious underlying health condition that can put you at increased risk (like a condition that impairs your lung or heart function or weakens your immune system), stay home and away from other people.

Slow the spread of coronavirus

All of us must do our part to slow the spread of the Coronavirus. Here’s how to help:

  • Avoid social gatherings in groups of more than 10 people.
  • Avoid close contact (6 feet, which is about two arm lengths) with people who are sick.
  • Work or engage in schooling from home whenever possible.
  • Avoid eating or drinking at bars, restaurants, and food courts — use drive-thru, pickup, or delivery options.
  • Avoid discretionary travel, shopping trips, and social visits.

Hygiene precautions to take now

  • Wash your hands often with soap and water for at least 20 seconds, especially after being out in public, blowing your nose, coughing, or sneezing.
  • If soap and water aren’t available, use a hand sanitizer that contains at least 60% alcohol.
  • To the extent possible, avoid touching high-touch surfaces in public places, like elevator buttons, door handles, handrails, and handshaking with people. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • Avoid touching your face, nose, and eyes.
  • Clean and disinfect your home to remove germs: Practice routine cleaning of frequently touched surfaces—tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and cell phones.

Preparing for healthcare needs

  • Be sure you have over-the-counter medicines and medical supplies (like tissues) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you’ll be prepared to stay at home for a period of time.

Coping with stress

Older people are at higher risk for severe illness from COVID-19 which may result in increased stress during a crisis. Here are a few things you can do to cope with that stress:

  • Take breaks from watching, reading, or listening to news stories and social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.
  • Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
  • If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others, call 
    • 911
    • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746 (TTY: 1-800-846-8517).

Medicare covers related needs

  • Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs.
  • Medicare covers all medically necessary hospitalizations. 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.
  • At this time, there’s no vaccine for COVID-19. However, if one becomes available, it will be covered by all Medicare Prescription Drug Plans (Part D)
  • If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits beyond the ones described below. Check with your plan about your coverage and costs.
  • Scammers may use the coronavirus national emergency to take advantage of people while they’re distracted. As always, guard your Medicare card like a credit card, check Medicare claims summary forms for errors, and if someone calls asking for your Medicare Number, hang up!

Telehealth & related services 

Medicare has temporarily expanded its coverage of telehealth services to respond to the current Public Health Emergency. These services expand the current telehealth covered services, to help you have access from more places (including your home), with a wider range of communication tools (including smartphones), to interact with a range of providers (such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social worker). During this time, you will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling and preventive health screenings without a copayment if you have Original Medicare. This will help ensure you are able to visit with your doctor from your home, without having to go to a doctor’s office or hospital, which puts you and others at risk of exposure to COVID-19.

  • You may be able to communicate with your doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit. Medicare pays for “virtual check-ins”—brief, virtual services with your physician or certain practitioners where the communication isn’t related to a medical visit within the previous 7 days and doesn’t lead to a medical visit within the next 24 hours (or soonest appointment available). 
  • You need to consent verbally to using virtual check-ins and your doctor must document that consent in your medical record before you use this service. You pay your usual Medicare coinsurance and deductible for these services. 
  • Medicare also pays for you to communicate with your doctors using online patient portals without going to the doctor’s office. Like the virtual check-ins, you must initiate these individual communications. 
  • If you live in a rural area, you may use communication technology to have full visits with your doctors. The law requires that these visits take place at specified sites of service, known as telehealth originating sites, and get services using a real-time audio and video communication system at the site to communicate with a remotely located doctor or certain other types of practitioners. Medicare pays for many medical visits through this telehealth benefit. 

Other ways Medicare is helping

Every day, Medicare is responsible for developing and enforcing the essential health and safety requirements that health care providers must meet. When you go to a healthcare provider, you expect a certain standard of care, and we work to make sure you get it. That includes taking additional steps in response to coronavirus:

  • Taking aggressive actions and exercising regulatory flexibilities to help healthcare providers and Medicare health plans.
  • As part of an effort to address the urgent need to increase capacity to care for patients, hospitals can now provide hospital services in other healthcare facilities and sites that aren’t currently considered part of a healthcare facility. This includes off-site screenings.
  • Waiving certain requirements for skilled nursing facility care.
  • Establishing new codes to allow providers to correctly bill for services related to diagnosis and treatment of the illness.
  • Instructing our national network of State Survey Agencies and Accrediting Organizations to focus all their efforts on infection prevention and other cases of abuse and neglect in nursing homes and hospitals.
  • Instructing nursing homes and hospitals to review their infection control procedures, which they’re required to maintain at all times.
  • Issuing important guidance answering questions that nursing homes may have with respect to addressing cases of COVID-19.

Related resources

Author:

The body always knows what to do to heal itself. The challenge is listening and doing what your body needs. I was diagnosed with Osteoarthritis in 2012, Avascular Necrosis aka Osteonecrosis in my knee in 2014 and Factor V Leiden hetero, and Spondylolisthesis 2016 Health Advocate-Health Activist-World Changer Love photography, cooking, hiking, walking ,traveling and learning to live a new normal since my diagnosis. My Links Facebook Main Profile https://www.facebook.com/debbie.briglovichandio Main Blog www.ChronicallyGratefulDebla.com Twitter - https://twitter.com/debbiea001 Instagram - https://www.instagram.com/debbiea_1962 and https://www.instagram.com/chronicallygratefulme Support Group Avascular Necrosis/Osteonecrosis Support Int’l https://m.facebook.com/groups/DeadBoneDiseaseAvn Awareness for Avascular Necrosis & Other Conditions of The Bone and Joints https://www.facebook.com/AvascularNecrosisAndBoneDiseaseAwareness/ Avascular Necrosis Awareness Day November 29 – working with elected officials to get this recognized in all states https://www.facebook.com/AwarenessByDebla/ Avascular Necrosis-Osteonecrosis Knowledge and Education https://www.facebook.com/AvascularNecrosisEducation/ Facebook Link https://m.facebook.com/ChronicallyGrateful.Me/

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