The coronavirus has changed many things in the world, healthcare and Medicare included. But what will Medicare look like in a post-Covid world?
Well, there are some changes we’ve noticed, including increased access to telemedicine and mental health services. But that’s not all. Let’s take a closer look at how Medicare is adapting to a post-Covid world.
The telehealth coverage expansion makes sense during the pandemic due to social distancing measures. Also, Medicare covers the management and evaluation of mental illnesses done virtually. Seniors need remote access to mental health doctors during this time of crisis.
In addition to the virtual care expansion, Skilled Nursing facility care restrictions are being lifted. Medicare lifted the three-day qualifying hospital stay requirement for beneficiaries affected by the public health emergency.
Medicare will cover coronavirus testing and vaccines. The test will be at no cost to you, same with the vaccine. For the test, beneficiaries won’t pay anything for the doctor’s visit or the testing. With the vaccine, Medicare Part B will cover the cost. Medicare Advantage plans will also cover testing and treatment the same as Medicare.
Medicare will cover treatment for Covid-19 the same way it would cover treatments for other health issues. So, you can expect Medicare Part A to cover you when you obtain inpatient care and Part B to cover your treatment in an outpatient setting. Many older adults will use a Medigap plan to cover the costs Medicare would otherwise leave you to pay.
During the coronavirus, Medicare Advantage plans, also known as Part C, must cover out-of-network services. Those that obtain care out-of-network shouldn’t be charged more than if they went to an in-network doctor.
Also, an increasing amount of Advantage plans are covering telehealth, transportation, meal delivery services, and long-term care. Beyond coverage, Medicare Advantage plans are the lowest premiums overall since 2007.
Beneficiaries that request a 90-day supply of medication will be provided with their drugs with coverage through their Part D plan. Further, Part D plans must cover out-of-network pharmacies when beneficiaries can’t use a network pharmacy.
At this time, Respite care expansion through Medicare hasn’t taken place. Medicare will continue to cover short-term medically necessary respite care for up to 5 consecutive days when obtained in a Medicare-approved facility.
Insurance companies may consider Covid A Pre-Existing Condition. Yet, Medicare is a public health program available to anyone with or without a pre-existing condition. Really, the bigger question is, “will Medigap consider coronavirus a pre-existing condition”? Well, it’s likely, but we can’t predict that at this time.
Telehealth is one service that has grown in participation since the pandemic began. Since the telehealth market expects to grow from a $25.4 billion industry to a $55.6 billion industry by 2025, we can expect more care to be done virtually.
For Skilled Nursing, it’s likely the requirements for a stay will be enforced once Covid is over. Eventually, there may be changes, but this benefit is one of those everchanging services.
Medicare covers many vaccines and tests. It only makes sense that they would continue to cover these services, whether it’s the current coronavirus or a future pandemic.
As for Medicare Advantage plans and Part D plans, some of the coverage expansions will remain. I imagine Part C will continue to add benefits Medicare doesn’t include. But, with out-of-network coverage, it’s unlikely that plans would continue to provide coverage for years to come.
While Medicare doesn’t really currently cover respite care, benefits may change in the future.
I’m sure when Medicare began back in 1965, they didn’t even consider the idea of telehealth. Well, now we’re here with Medicare coverage for a virtual doctor visit. Covid changed things for everyone. But the reality is that Medicare is always changing, Covid, or no Covid.
What are you most concerned about when it comes to Medicare in 2021? Have you used telehealth in the past year? What was the experience like? Which Medicare changes are you anticipating the most? Please share below.