Healthcare Educators


COVID-19 and How Medicare Covers Testing

by | Mar 26, 2020

The novel coronavirus is spreading through the United States. Many people have tested positive for COVID-19, the official name for the coronavirus disease. If you think you need to be tested for the virus, here’s what you should know about coverage under Medicare.

Who Should Get the COVID-19 Test?

There have been widespread reports of people being unable to get tested for coronavirus due to supply shortages. At this point, testing has increased, but there may still be restrictions and limits.

According to the CDC, not everyone needs to be tested for coronavirus.

  • If you have been exposed to COVID-19 and have coronavirus symptoms, you should call your doctor or health care provider. Common symptoms of COVID-19 include fever, cough and shortness of breath.
  • If you experience emergency warning signs, you should seek medical help immediately. Emergency warning signs include trouble breathing, persistent chest pain or pressure, confusion, inability to arouse or bluish lips or face.

How Does Medicare Cover the COVID-19 Test?

COVID-19 testing is covered by Medicare when the test is ordered by your doctor or health care provider on or after February 4, 2020. Medicare covers lab tests for COVID-19 with no out-of-pocket costs, and Medicare Advantage plans may waive cost-sharing.

There is currently no vaccine, but when one becomes available, it will be covered under your Medicare Prescription Drug Plan.

How Should Medicare Enrollees Get Tested?

Watch out for scammers trying to take advantage of people’s fear surrounding the coronavirus. Medicare warns that if someone calls you offering tests and asking for your Medicare Number, you should hang up.

If you think you need to be tested for COVID-19, contact your doctor to see how you should proceed with testing. You can start with a phone call to reduce the chance of contagion. Medicare has also temporarily expanded telehealth coverage, and patients can initiate virtual check-ins or use of online patient portals. Some Medicare Advantage plans already offer expanded telehealth benefits.

If you are experiencing a medical emergency, call 911 for immediate assistance.

What Else Should People Do?

  • People are being asked to avoid gatherings of more than 10 people and to stay home whenever possible. Some states have issued “Stay at Home” orders with additional restrictions. If you are high risk because of your age or other health conditions, self-isolation is especially important.
  • Practice good hygiene to limit the spread of infection. Cover your mouth if you sneeze or cough, wash your hands often and for 20 seconds, avoid touching your face and disinfect high-touch areas frequently.
  • If you take prescription drugs, contact your plan to see if you can refill your prescriptions early. Some plans may waive certain refill restrictions to ensure that enrollees have an adequate supply of all necessary medications during the pandemic.

If you have questions or need help with your Medicare plan, PTT Financial is here for you. Contact us anytime.