Many people have a lot of questions about Covid-19 and Medicare. How much will you pay for the vaccine? Does Medicare cover hospitalization costs for Covid-19? How much will it cost you to get tested for the virus if you’re sick? We’ll address these questions and more below.
Medicare Patient FAQs About Covid-19 Vaccines
At this time, anyone in the United States aged 16 and older can sign up for a free Covid-19 vaccine. There are now federally funded, publicly available vaccination sites in every state. Medicare also covers the vaccine if your primary care provider gives you the shot during an office visit. Plus, you’ll owe no copays or deductible charges for that office visit if it’s the only service you receive.
Here are answers to the most common questions patients ask about the Covid-19 vaccines:
- People with egg allergies can take any adenovirus or mRNA Covid-19 vaccine. None of the current vaccines contain any egg proteins and should not cause an allergic reaction.
- Both mRNA vaccines (Moderna and Pfizer) are safe for immunocompromised patients, such as people undergoing chemotherapy for cancer.
- All Covid-19 vaccines are safe for people with latex allergies because the vial stoppers don’t contain any natural rubber latex.
- Vegans can safely take any Covid-19 vaccine, as none contain gelatin or egg protein-based ingredients or fillers.
- People allergic to polyethylene glycol (PEG) should not get the mRNA vaccines (Moderna or Pfizer). PEG is an ingredient used in both mRNA vaccines, but the Johnson & Johnson vaccine is PEG-free.
- Anyone allergic to polysorbate should avoid the Johnson & Johnson Covid-19 vaccine. This is an ingredient used in the J&J vaccine, but the Moderna and Pfizer shots are polysorbate-free.
- Anyone who receives a Covid-19 vaccination shot must stay under a doctor or pharmacist’s observation for 15 minutes afterwards. This observation period allows medical professionals to monitor patients for allergic or adverse reactions and provide immediate treatment, if needed. Allergic reactions are extremely rare; about 1 in 1,000,000 people vaccinated may require treatment with an epi-pen.
Medicare Annual Enrollment Period Starts 10/15
$0 monthly premium Medicare Advantage plans may be available in your state.
Does Medicare Cover Covid-19 Tests?
If you or your doctor suspect you’re sick with Covid-19, Medicare covers your lab test. That means you pay no out-of-pocket costs for that test or your doctor’s office visit. Medicare also covers antibody testing for anyone who suspects a prior (but unconfirmed) Covid-19 infection. This benefit applies equally to patients covered under Original Medicare and Advantage plans.
Original Medicare patients can also schedule free virtual doctor’s visits using telehealth communication technology (i.e., smartphones, web browsers, etc.). These telehealth visits can replace in-person routine doctor’s appointments, such as renewing prescription medications or preventive health screenings.
What Treatments Does Medicare Cover?
While you have active Medicare Part B coverage, you’ll pay nothing for monoclonal antibody treatments for mild-to-moderate Covid-19. You must receive this treatment via intravenous infusion (IV) in either a clinic or hospital from an authorized healthcare provider.
If your doctor determines that hospitalization is medically necessary to treat your Covid-19, Medicare covers that stay. Your hospital must accept Medicare to receive this benefit, but it includes both Original Part A and Medicare Advantage plans. In addition, Medicare Advantage plans must charge in-network costs for out-of-network care.
Here’s how to estimate your out-of-pocket Medicare Part A hospitalization costs:
- $1,484 deductible
- $0 coinsurance for days 1-60 per benefit period
- $371 daily coinsurance charge for days 61-90 per benefit period
- $742 daily “lifetime reserve day” charge for days 91+ (no more than 60 days total over your lifetime Medicare coverage)
Original Medicare covers the following during a medically required hospital stay for Covid-19:
- Semi-private rooms
- General nursing services
- Drugs prescribed during your inpatient stay
- Other hospital services and supplies relevant to your inpatient treatment for Covid-19
Patients with Medicare Part D or Medicare Advantage plans may owe a coinsurance charge once they meet their annual deductible. The yearly deductible for all Medicare drug plans in 2021 is no more than $445, though many are cheaper. If your doctor prescribes any medication to treat your Covid-19 symptoms, Medicare Part D or Medicare Advantage should cover it.