In this Q&A series, Medicare expert Christian Worstell answers your questions about Medicare coverage, benefits, eligibility, enrollment and more. Christian is a licensed insurance agent and frequent contributor to MedicareAdvantage.com.
"My husband was just released from the hospital after battling COVID-19. Fortunately, he’s going to be okay. But now we are worried about the upcoming medical bills. He has Medicare Part A, Part B and Part D. How much should we anticipate having to pay?" – Barb N., Scottsdale, AZ
I’m glad you’re both okay; that of course is the most important thing. Now to your question.
Original Medicare (Part A and Part B) and all Medicare Advantage plans (Part C) provide full coverage for the following services and treatments related to COVID-19:
This means you won’t pay a dime out-of-pocket for Medicare-approved COVID-19 tests or a vaccine.
Medicare provides the same coverage for inpatient hospitalizations due to COVID-19 as it does for all other covered conditions, under the same guidelines regarding deductibles, coinsurance and copayments.
If your husband visited a doctor to undergo a COVID-19 test, the test and the doctor’s visit will both be covered in full. He should not expect to be billed for the office visit that was required to take the test.
Part A (which covers hospital stays) requires a deductible of $1,408 per benefit period in 2020. Once that is satisfied, your husband would then not be responsible for any further Part A out-of-pocket costs related to his hospital stay itself (assuming his hospital stay lasted less than 60 days).
Depending on what types of services and items were administered to your husband during his stay, it’s possible that he may incur charges for his Part B deductible or coinsurance. In 2020, the Medicare Part B deductible is $198 for the year, and you typically pay a 20 percent coinsurance cost for Medicare approved treatment after meeting your deductible.
You may want to check with your Part D plan carrier to see how those medications will be covered under his plan.
If you believe your husband has incurred unfair or incorrect charges as a result of his COVID-19 treatment, he has the right to file an appeal. You can learn more about his rights as a Medicare beneficiary here.
Medicare has also expanded its coverage of telehealth services to allow patients to consult with their doctor virtually and limit the amount of in-person contact during the coronavirus pandemic.
Medicare has also expanded certain other benefits during the COVID-19 outbreak, such as loosening prescription drug refill limits.
Thanks for your question, and here’s wishing your husband a full recovery.
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