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.
"I hope to get a COVID-19 vaccine as soon as one becomes available. However, I only have Original Medicare and do not have any prescription drug coverage. Do I need to enroll in a Medicare Part D plan during open enrollment in order to have COVID-19 vaccine coverage in the future?" – Terry C., Aurora, CO
Hi Terry. Thanks for your question, and no, you will not need to be enrolled in any Medicare prescription drug plans in order to obtain a COVID-19 vaccine.
The vaccine (if and when one becomes available) is one of the core COVID-related services that are covered in full by Original Medicare (Medicare Part A and Part B) and Medicare Advantage (Medicare Part C) plans.
Under a provision in the CARES Act, if a vaccine becomes available for COVID-19, it will be covered by Medicare Part B with no cost sharing for beneficiaries. That means you will not have to pay anything toward your Part B deductible or pay any Part B coinsurance for the vaccine, as long as your health care provider accepts Medicare assignment.
You also won’t owe anything for Medicare-approved services related to obtaining the vaccine, such as a doctor’s visit. This applies to beneficiaries with both Original Medicare and Medicare Advantage plans.
Medicare Part B and Medicare Advantage plans provide coverage for a number of vaccinations such as influenza, pneumococcal and Hepatitis B. These vaccines are not subject to the Part B deductible or coinsurance.
If a vaccine becomes available, it should eventually be available at doctor’s offices and pharmacies similar to a flu shot. It may take some time for the vaccine to be widely available, however.
While you do not need to enroll in a prescription drug plan in order to receive full coverage of the COVID-19 vaccine, it’s typically a good idea to enroll in some form of prescription drug coverage.
Even if you are not taking any prescription drugs now, you never know when you might become sick or injured and may be prescribed some medication for treatment. And you may not be able to simply enroll in such a plan the moment you need it.
Medicare prescription drug coverage from a Medicare Advantage plan that covers drugs or from a standalone Medicare Part D plan is a good thing to have and an even better thing to not have to use.
Stay safe out there and stay up to date on how Medicare is helping serve beneficiaries during the coronavirus pandemic.
If you have any additional questions about the Medicare plans available near you that provide drug coverage, you can call today to speak with a licensed insurance agent who can help you compare plan costs, find out what plans cover your drugs and – if you’re eligible – help you sign up for the right plan for you.
You can also compare plans online for free, with no obligation to enroll.
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