Will Medicare Cover COVID-19 Hospital Stays

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COVID-19 took the world by surprise earlier this year. As several countries still fight the rapidly spreading disease, many seniors wonder how Medicare will cover a hospital stay if they were to test positive for COVID-19. Fortunately, Medicare has adjusted some of its rules and restrictions due to the pandemic. American seniors will be happy to know that Medicare would cover their COVID-19 hospital stays in the case they are infected. 

How COVID-19 affects seniors

While people of all ages are at risk for developing COVID-19, seniors are at a higher risk for significant complications from the disease. Seniors should seek medical attention as soon as they suspect they have COVID-19. 

The typical symptoms that concern the population are continuous dry cough, fever, and shortness of breath. However, seniors have experienced other symptoms that Medicare beneficiaries and caregivers should be on the lookout for. According to Kaiser Health News, many physicians have claimed that seniors may experience atypical symptoms like dizziness, lack of appetite, fatigue, and confusion.

If these symptoms are present, the first step will be to get tested for COVID-19. Medicare Part B covers COVID-19 diagnostic tests at 100% if it is administered in a lab, pharmacy, doctor’s office, hospital, and in some situations at home. If the test is positive, the next step for seniors would be to check into the hospital. 

How Medicare covers COVID-19 hospital stays

Medically necessary hospital stays are covered under Part A if the beneficiary is officially admitted as an inpatient. COVID-19 patients will also receive extended hospital stay coverage if they need to remain in the hospital for quarantine. However, hospital stays aren’t 100% covered, like the COVID-19 tests are. 

According to the Centers for Medicare and Medicaid Services (CMS), half of the Medicare beneficiaries hospitalized due to COVID-19 had hospital stays lasting at least eight days. Some stays were closer to a month. Fortunately, Medicare Part A covers the first 60 days of an inpatient hospital stay after the beneficiary pays the deductible. However, the Part A deductible is $1,408 in 2020. 

While COVID-19 hospitalizations don’t tend to surpass the 60-day mark, if one did, here’s what a Medicare beneficiary would have to pay. In 2020, for hospital stays lasting between 61 and 90 days, the beneficiary would pay $352 a day after day 60. If the hospital stay continued past 90 days, the daily copay would increase to $704 a day. If, on the off chance, the stay goes beyond 150 days or about five months, the beneficiary would be responsible for 100% of the costs from that day forward. Many beneficiaries may have help with these Medicare costs, though, if they are enrolled in supplemental coverage like Medigap coverage.

Medicare coverage for telehealth during the pandemic

Telehealth allows doctors to visit with their patients remotely via telecommunication software. Before the spike of the COVID-19 pandemic, Medicare covered telehealth services only under certain circumstances. However, now that seniors are urged to stay home, Medicare updated its telehealth rules to broaden its coverage. 

Medicare beneficiaries can now receive telehealth visit coverage for doctor visits, psychotherapy, consults, and other types of medical appointments regardless of location. During the pandemic, Medicare will cover these telehealth visits like normal in-person visits. Therefore, beneficiaries will have normal cost-sharing expenses unless the doctor’s office choose to waive them.

Medicare Part B covers doctor visits, included those done via telecommunication. The Part B deductible and coinsurance apply. In 2020, the Part B annual deductible is $198. If the deductible has already been satisfied, the beneficiary will only be responsible for the Part B 20% coinsurance.

However, if the beneficiary has a Medigap plan that covers the Part B coinsurance at 100%, the beneficiary will be left owing nothing. Medicare Advantage plans are a different story. While Medicare Advantage plans are required to cover telehealth services during this time, the cost-sharing expenses may be different, so beneficiaries should consult their plan’s Summary of Benefits to determine what copayment may be due at the time of service.

Seniors should also note that some doctors aren’t offering telehealth services. Doctors are not required to provide this special service to their patients. The good news is, if a doctor does provide telehealth services, seniors patients can rest assured knowing that Medicare has their backs.

Medicare has adapted to the current state of the country. Medicare beneficiaries should find that their coverage reflects that for both inpatient and outpatient services. 

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