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Medicare wants to help protect you from COVID-19:
Your health, safety, and welfare in the face of the coronavirus disease 2019 (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.
Medicare covers the COVID-19 vaccine
Pharmaceutical manufacturers are distributing the vaccine to federally and state-approved locations. Each state has its own plan for deciding who they’ll vaccinate first and how residents can get vaccines. Contact your local health department for more information on COVID-19 vaccines in your area. Learn more about COVID-19 vaccine progress. Medicare covers the vaccine at no cost to you. Be sure to bring your Medicare card so your health care provider or pharmacy can bill Medicare.
If you paid to get a COVID-19 vaccine
When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.
If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you:
- Check the receipts and statements you get from your provider for any mistakes.
- Call your provider’s office to ask about any charges you think are incorrect. The person you speak to may help you better understand the services you got, or realize they made a billing error.
- If you have Original Medicare, review your “Medicare Summary Notice” for errors. Report anything suspicious to Medicare by calling 1-800-MEDICARE (1-800-633-4227).
- If you have other coverage like a Medicare Advantage Plan, review your “Explanation of Benefits.” Report anything suspicious to your insurer.
If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of Health and Human Services by calling 1-800-HHS-TIPS or visiting TIPS.HHS.GOV.
Be alert for scammers trying to steal your Medicare Number. Medicare covers the vaccine at no cost to you, so if anyone asks you for your Medicare Number to get access to the vaccine, you can bet it’s a scam.
Here’s what to know:
- You can’t pay to put your name on a list to get the vaccine.
- You can’t pay to get access to a vaccine.
- Don’t share your personal or financial information if someone calls, texts, or emails you promising access to the vaccine for a fee.
Protecting yourself & others
- Wear a mask that covers your mouth and nose.
- Stay at least 6 feet (about 2 arm lengths) from others who don’t live with you, particularly in crowded areas.
- Avoid crowds and indoor spaces as much as possible, particularly ones that aren’t well ventilated. Learn more about daily activities and going out.
- Wash your hands often.
- Watch for symptoms.
- Stay home if you think you’ve been exposed to COVID-19.
- Learn what to do if you are sick with COVID-19 or think you might have COVID-19.
Coping with stress
Older people are at higher risk for severe illness from COVID-19 which may result in increased stress during a crisis. Learn healthy ways to cope with that stress.
Medicare covers related needs
- Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs.
- Medicare covers FDA-authorized COVID-19 antibody (or “serology”) tests if you were diagnosed with a known current or known prior COVID-19 infection or suspected current or suspected past COVID-19 infection.
- Medicare covers monoclonal antibody treatments for COVID-19.
- Medicare covers FDA-authorized COVID-19 vaccines. 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. You’ll still pay for any hospital deductibles, copays, or coinsurances that apply.
Military hospital ships and temporary military hospitals don’t charge Medicare or civilians for care. If you’re not sure whether the hospital will charge you, ask them.
- 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 and expanded benefits, like meal delivery or medical transport services. 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 (like doctors, nurse practitioners, clinical psychologists, licensed clinical social workers, physical therapists, occupational therapists, and speech language pathologists). 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.
- Because some people don’t have access to interactive audio-video technology needed for Medicare telehealth services, or choose not to use it even if offered by their practitioner, Medicare is allowing people to use an audio-only phone.
- 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.
- Fraud alert: Watch out for providers you don’t know or haven’t met before contacting you to set up a telehealth appointment. They may offer you perks like cash payments or free prescription drugs to get your personal information, and then start billing Medicare for items and services you didn’t need or you didn’t get, like lab tests, braces or orthotics. If you suspect fraud, call 1-800-MEDICARE.
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:
- Medicare Advantage Plans and Prescription Drug Plans may waive or relax prior authorization requirements.
- 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. Medicare covers medically necessary care in these facilities and sites.
- 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.