Coronavirus & Medicare

Medicare will cover coronavirus tests & doctor visits.

Here’s how to get one if you think you have symptoms

Call your doctor. Lab services are covered by Original Medicare and Medicare Advantage plans, but if you want a random test out of the blue, it would not be covered if there’s no medically necessary reason for it. If you suspect you may have been exposed to the COVID-19 virus, call your doctor and in the current environment, if your doctor is concerned, they will say the test is medically necessary. If your doctor bills you for an office visit, that office visit will also be covered.

Let’s discuss the various ways that Medicare will cover the testing and medical care for the two different types of Medicare plans.

Original Medicare and Medicare Advantage plans:

If you have a Medicare Advantage Plan (Part C) in Maine.

Most Medicare Advantage plans in Maine have announced they will waive co-pays for all diagnostic testing related to COVID-19, That includes all member costs associated with diagnostic testing.

Some plans are also offering zero co-pay telemedicine visits for any reason as well as expanding several programs to help people address associated anxiety and stress.

If you have a Original Medicare & a Supplement (Medigap).

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. You usually pay nothing for Medicare-covered clinical diagnostic laboratory tests.

Mother always said, “An ounce of prevention is worth a pound of cure.” And she was right!

While the average risk of contracting COVID-19 remains low in the U.S., top experts now warn people in high-risk groups to be cautious – especially if they are elderly and have an underlying medical condition.

“Avoid large crowds, no long trips and above all, don’t get on a cruise ship,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview on NBC’s “Meet the Press.”

The Centers for Disease Control and Prevention recommends that high-risk individuals stock up on supplies (such as extra medications and groceries), keep space between yourself and others, wash your hands often and avoid crowds. And, if there is an outbreak in your community, remain at home as much as possible.

Symptoms of COVID-19 include fever, cough, shortness of breath and difficulty breathing. Severe cases can lead to pneumonia, severe acute respiratory syndrome, kidney failure and death, according to the World Health Organization.

If you develop any symptoms that are concerning, you should contact your primary-care provider — by phone — for guidance. The CDC has encouraged providers to use their best judgment for who should be tested, which may be based on your symptoms or other factors such as known exposure to an infected person.

If your doctor or other provider thinks you need testing, they’ll contact their local health department or the CDC for instructions on where you can get the test, according to the National Institutes of Health.

The test may involve a swab, blood draw or other method, depending on where the test is administered.

If you have further questions about how your plan will cover testing or treatments call 1-800-Medicare or call the phone number for Member Services on the back of your insurance card.

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