What You Need to Know About Coronavirus and Medicare Coverage

Emily WhicheloeMedicare Answers, Medicare WatchLeave a Comment

We will provide updates and information on this page as available. If you have questions about your Medicare coverage and the coronavirus national emergency, please review the resources below and call our National Helpline at 800-333-4114.

Update 3/27/20: Congress passed and the President signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748). Relevant changes have been made below.

Update 3/20/20: Medicare Rights now has a flier with information about Medicare coverage and coronavirus. Download the flier here.

Update 3/18/20: ​Congress passed and the President signed into law the Families First Coronavirus Response Act (H.R. 6201). Relevant changes have been made below.

Update 3/16/20: Our Mission is Unchanged: A Message from Medicare Rights President Fred Riccardi

Original post 3/12/20: As the number of cases of COVID-19 (also called coronavirus) increases, so does the importance of programs like Medicare in helping older adults, people with disabilities, and their families build and maintain their health and economic security. Accordingly, policymakers are taking critical steps to ensure program preparedness, keep beneficiaries and the public informed, and facilitate timely access to appropriate care.

The Centers for Medicare & Medicaid Services (CMS) is working to address the spread of the disease and inform people with Medicare about the services that Medicare covers. The Centers for Disease Control and Prevention (CDC) has identified older adults and people with serious chronic medical conditions like heart disease, diabetes, and lung disease as being at higher risk from the virus.

In general, Medicare covers medically necessary items and services that a beneficiary receives from a provider who accepts Original Medicare or is in-network for the beneficiary’s Medicare Advantage Plan. Medicare Advantage Plans must cover everything that Original Medicare does, but they can do so with different costs and restrictions.

Medicare-covered services related to coronavirus include:

Note: If a beneficiary has Medicare and Medicaid, Medicaid may cover additional services as long as the beneficiary sees providers who accept Medicaid. Contact the local Medicaid office for more information.

Accessing services during public health emergency

Medicare Advantage Plans and Part D plans usually have networks of providers and pharmacies that beneficiaries must use in order to receive covered services at the lowest cost.

During emergencies, Medicare Advantage Plans must work to maintain access to health care services and prescription drugs for plan members living in affected areas. Plans must meet certain requirements following the declaration of a disaster, emergency, or public health emergency. For example, Medicare Advantage Plans must charge in-network cost-sharing amounts for services received out of network. Visit Medicare Interactive to learn more about requirements for Medicare Advantage and Part D plans during a public health emergency.

At this time, Medicare has also given plans the flexibility to make optional changes to their cost-sharing and coverage. These optional changes include:

  • Removing prior authorization requirements
  • Removing prescription refill limits
  • Relaxing restrictions on home or mail delivery of prescription drugs

Every Medicare Advantage and Part D plan is different. Beneficiaries should contact their plan directly to learn about how it covers services related to coronavirus.

For more information or help accessing Medicare benefits:

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