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Sharp Health News

What Medicare recipients need to know about COVID-19

March 16, 2020

Older couple looking at paperwork

According to the Centers for Disease Control and Prevention (CDC), adults over the age of 60 and those with chronic medical conditions are at a higher risk of severe illness if they contract the new coronavirus disease, also known as COVID-19. This leaves many people with Medicare wondering what precautions they should be taking to avoid becoming ill, and what Medicare may cover if treatment for the disease is required.

The CDC continues to recommend that people of all ages take the following precautions:

  • Avoid close contact with people who are sick.
  • Don't leave your home unless it is for an essential trip.
  • If you leave your home, practice social distancing and wear a face covering.
  • Wash your hands often with soap and warm 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.
  • Avoid touching your face, nose and eyes.
  • Avoid touching frequently touched surfaces in public places, like elevator buttons, door handles and handrails.
  • Avoid shaking hands with other people.
  • Clean and disinfect frequently touched surfaces in your home, such as counters, doorknobs, light switches, handles, bathroom fixtures and cellphones.

Medicare is now also advising that members take extra caution and follow these additional guidelines:

  • Avoid social gatherings in groups of more than 10 people.
  • Work or engage in schooling from home whenever possible.
  • Avoid eating or drinking at bars, restaurants and food courts.
  • To get take-out, use drive-thru, pickup or delivery options.
  • Avoid discretionary travel, shopping trips and social visits.

It is also important that you prepare for any health care needs, including ensuring you have sufficient amounts of your prescription medications, as well as over-the-counter medicines that treat fever and other symptoms of COVID-19.

Furthermore, it is recommended that you have enough household items and groceries on hand so that you'll be prepared to stay at home for a period of time, either to avoid being exposed to COVID-19 or if you become ill due to COVID-19. Most people will be able to recover from COVID-19 at home.

What to do if you have symptoms of a respiratory illness
If you have a fever and respiratory illness, it is recommended to call ahead to your health care provider before you show up at their facility. This will allow them to make proper arrangements for your visit.

What Medicare covers
Medicare covers a variety of needs related to COVID-19, including:

  • Lab tests for COVID-19 — no out-of-pocket costs will be incurred.
  • FDA-authorized COVID-19 antibody (or "serology") tests if you were diagnosed with a COVID-19 infection or are suspected of having a past COVID-19 infection.
  • All medically necessary COVID-19-related hospitalizations.
  • "Virtual check-ins" — brief, virtual services with your established doctor or certain practitioners where the communication isn't related to a medical visit within the previous seven days and doesn't lead to a medical visit within the next 24 hours (or soonest appointment available).
  • If you live in a rural area, you may use communication technology to have full visits with your doctors. Also, you can get these visits at rural health clinics and federally qualified health clinics. Medicare pays for many medical visits through this telehealth benefit.

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).

You need to consent verbally to using virtual check-ins and your doctor must document that consent in your medical record before you use the service. You must also initiate individual communications to communicate with your doctor via your online patient portal. You will pay your usual Medicare coinsurance and deductible for these services.

If you have a Medicare Advantage Plan, you have access to these same benefits. Many plans offer additional telehealth benefits. Check with your plan about your coverage and costs.

Staying safe while getting care
Although providers and facilities will continue to use telehealth services when available and appropriate, they will offer more in-person health care services for non-emergency and non-COVID-related care. Providers and facilities will minimize exposure, so you may experience some changes during your visit, including:

  • Waiting in your vehicle until the start of the visit
  • Using a limited entrance
  • Being screened for COVID-19, including having your temperature checked
  • Avoiding waiting rooms and areas
  • Maintaining social distancing
  • Wearing a face covering, which will be provided to you if you don't have your own

Scam warning
Medicare.gov has issued a warning that scammers may use COVID-19 as an opportunity to steal your identity and commit Medicare fraud. Be wary of suspicious callers, promising coronavirus tests, masks or other items in exchange for your personal information. Learn more by visiting Medicare's fraud site.

Call Medicare's help line at 1-800-633-4227 (TTY 1-877-486-2048) for general information and help with your coverage questions. Learn more about the CDC's COVID-19 prevention guidelines and latest news and what Sharp HealthCare is doing to screen for COVID-19.

This story was updated on June 24, 2020.

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