Medicare Coverage of COVID-19 Vaccines, Tests, and Treatments.

By Barbara Wilcox, SHIP Counselor

The COVID-19 Public Health Emergency ended May 11, 2023. Even though the emergency is over, the disease is still with us. It is recommended that we keep current with our vaccines and boosters, that we test for COVID if we get sick, and that we seek treatment from our doctors if we do get COVID. Medicare still covers these things that we need, but the method we use to obtain them may have changed. Here is a review of current status and procedures.

COVID-19 Vaccines: You pay nothing to get a vaccine or booster shot. If you are on Original Medicare, take your Medicare card to your doctor or pharmacy to get your shot. If you are on a Medicare Advantage Plan, use your Plan ID card and go to a provider in your plan’s network.

COVID-19 Tests: The process depends on whether you are going to a provider for a test done in a laboratory or are using a home test.

• Lab Test: You pay nothing if the test is ordered by a health care provider. If you are on Original Medicare, use your Medicare card. If you are on a Medicare Advantage Plan, go to a network provider and use your Plan ID card.

• Home tests: The procedure has changed for obtaining tests that you can use at home. There is no longer a central government web site to order tests, and they are no longer free. Instead, you buy tests for home use at a retail or online drug store. Prices that I checked seem to range from $4 to $6 per test. It is possible to get free tests online from programs that serve people on government insurance, but I find that it’s not easy to find them.

COVID Treatments: If you are hospitalized, require doctor visits, need prescriptions or any other treatments for disease, then Medicare covers you as it normally does under Part A, Part B and Part D. In addition, Medicare.gov gives the following information about treatment specifically for COVID.

Medicare Part B (Medical Insurance) covers FDA-authorized COVID-19 monoclonal antibody treatments and products, if all of these apply:

• You tested positive for COVID-19.

• You have a mild to moderate case of COVID-19.

• You’re at high risk of progressing to a severe case of COVID-19 and/or at high risk of requiring hospitalization.

Medicare Advantage Plans also cover you as they normally do and are required to give you coverage at least as good as Original Medicare. Now that vaccines, tests and treatments are widely available, COVID-19 is no longer causing the numbers of severe illnesses, hospitalizations and deaths that it caused early in the pandemic. We can be glad that Medicare covers nearly all of it, and we can do a lot to protect ourselves from this disease.

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