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Sen. Schumer to Medicare: Cover the Coronavirus Vaccine

Published March 5, 2020

Follow our Medicare Coronavirus News page for related information on coronavirus (COVID-19) and its impact on Medicare beneficiaries.

Senate Minority Leader Chuck Schumer is campaigning to have a coronavirus vaccine covered by Medicare. 

A vaccine for the virus (COVID-19), which infiltrated the U.S. in February after weeks of global spread, is still being developed, with no timetable for when one might be available for distribution. 

Schumer called for Medicare to cover the vaccine when and if one does become available, saying at a press conference that his plan to have Medicare fully cover the cost of the vaccine “will mean no senior will be forced to make the choice between shelling out and going without.”   

Does Medicare currently cover vaccines?

Medicare is the nation’s largest health insurance provider and covers around 65 million American seniors and people with disabilities.

Medicare Part B currently offers coverage for a number of vaccines including the flu and shingles. Other vaccines, such as tetanus, are typically covered Medicare Part D prescription drug plans and Medicare Advantage (Medicare Part C) plans that offer prescription drug coverage. 

Schumer outlined a plan to add a provision to the spending package currently being negotiated in Congress that would allow those on Medicare to receive a coronavirus vaccine free of charge.

The coronavirus has so far affected older adults at a far greater rate than younger people. Eligibility for Medicare begins at age 65, or younger, with a qualifying disability. 

While no cost estimate has been prepared, a spokesperson for Schumer said it will save money in the long term if the vaccine prevents people from getting sick and requiring costly treatment. 

The Trump administration allocated $2.5 billion to fight the coronavirus. Schumer proposed an $8.5 billion plan that included $2 billion to reimburse state and local governments and $1 billion for vaccine development. 

Seema Verma issues Medicare response

Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), responded to Schumer’s proposal by saying that Medicare may not be able to pay for all products and services required for coronavirus patients. 

In a press briefing on March 2, 2020, Verma said, “We are looking at what we cover and clarifying the types of products and services that our programs will be able to pay for in terms of Medicare and Medicaid.”

During a Feb. 26 congressional hearing, Health and Human Services Secretary Alex Azar said, “We would want to ensure that we work to make (the vaccine) affordable, but we can’t control that price because we need the private sector to invest. Price controls won’t get us there.” 

Vaccines currently covered by Medicare are paid for by Medicare Part B, the optional portion of Medicare that covers outpatient care, durable medical equipment (DME) and many preventive services like vaccines, screenings and tests. 

Medicare Advantage plans could cover coronavirus vaccines

Medicare Advantage plans are sold by private insurance companies and cover the same benefits that are offered by Original Medicare (Medicare Part A and Part B). If Original Medicare were to offer a coronavirus vaccine, Medicare Advantage plans would also pay for the vaccine.

Most Medicare Advantage plans also cover prescription drugs, which Original Medicare doesn’t cover. Some plans may also cover things like routine dental and vision care, non-emergency medical transportation, home meal delivery and more.

You can call a licensed insurance agent to compare Medicare Advantage plans in your area, and you can compare plans online today to find the right coverage for your needs.

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