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Coverage changes • COVID-19 tests • Vaccines • Treatment • Consider this
Yes. Even though some COVID-19-related coverage changed after the pandemic’s public health emergency ended in May 2023, Medicare will still pay for coronavirus lab tests, vaccines and many forms of treatment.
But you need to follow special steps to get Medicare coverage or save money. The Centers for Disease Control and Prevention reports that COVID-19's summer surge is stretching into early fall.
Medicare no longer covers over-the-counter COVID-19 tests, but the government will resume offering free COVID tests at the end of September 2024. Each household can order up to four free COVID tests at COVIDtests.gov.
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You can also get COVID tests at many retail pharmacies, but you'll probably have to pay for them yourself.
Medicare Part B continues to cover coronavirus lab tests ordered by a health care provider. This can include polymerase chain reaction (PCR) tests or antigen tests that a laboratory processes. These tests are not subject to the Part B deductible and coinsurance if you have original Medicare and get tested at a pharmacy, clinic, doctor’s office or hospital that takes Medicare.
If you have a Medicare Advantage plan, your coverage may differ.
Even though Medicare doesn’t cover retailers’ COVID-19 tests, some Medicare Advantage plans give an allowance for over-the-counter drugs, which you can apply toward the tests. You may have a Medicare flex card to help pay for these expenses. Contact your plan for details. For example, most UnitedHealthcare Medicare Advantage (Part C) plans come with a UnitedHealthcare UCard credit every quarter for covered over-the-counter products, including OTC coronavirus tests.
Medicare Advantage plans must cover COVID-19 lab tests, but some plans charge copayments.
Does Medicare cover COVID-19 vaccines?
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After Congress passed the Inflation Reduction Act, Medicare began to cover many vaccines as a free preventive benefit with no cost-sharing. Medicare Part B covers the COVID-19 vaccine, including new FDA-approved vaccines, and providers who participate in Medicare can’t charge beneficiaries for the vaccine.
Medicare covers the vaccines that the CDC’s Advisory Committee on Immunization Practices recommends, says Juliette Cubanski, deputy director for KFF’s program on Medicare policy. The Washington-based nonpartisan group studies health policy issues.
Coverage is based on the vaccine type, who needs it, and the frequency the CDC recommends, she says.
Medicare Advantage plans must also cover COVID-19 vaccines as a free benefit if you use a provider in the plan’s network. You may have a copayment if you go out of network.
For example, Aetna Medicare Advantage PPOs make the vaccine available to members at no cost, regardless of an in-network or out-of-network provider. Under an Aetna Medicare Advantage HMO, the vaccine is available to members at no cost only when using a network provider. Humana provides similar coverage.
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