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March 4, 2021

How COVID-19 Has Affected Medicare Beneficiaries
Alli Thomas

Because of their age, most Medicare beneficiaries are considered to be at higher risk for complications associated with COVID-19.

Preliminary data from the U.S. government show that as of mid-September 2020, 1.2 million cases of COVID-19 were Medicare recipients. Of that number, over 332,000 required hospital stays: nearly half were hospitalized for between one and seven days, and about 5% required hospitalization for longer than 30 days.

According to research, 8 out of 10 Medicare recipients are worried about how they will pay for COVID-19 if they are to become infected. Respondents said their primary concern is having to pay high out-of-pocket expenses. After that, they named the following concerns:

  • Unexpected medical bills
  • Not being able to pay for monthly premiums
  • Having to forego medical care in order or prescription drugs to save on costs
  • Finding in-network doctors that they like.

If you share these concerns, read on.

How Much Might COVID-19 Care Cost for Medicare Beneficiaries?

Basic Medicare coverage (Parts A and B; also called original Medicare) has no limit on out-of-pocket spending. Although many Medicare beneficiaries do carry some form of additional coverage, such as Medigap insurance, those who don’t would pay the $1,484 deductible for Part A coverage if admitted to the hospital—a cost that would cover the first 60 days per benefit period. After the 60-day mark and up until the 90th day, the daily copay runs $371. After that, the daily copay rate jumps to $742.

Doctor visits—even from those medical care providers who treat beneficiaries while hospitalized—fall under Part B of Medicare. This year, Part B has a deductible of $203, and in most cases, beneficiaries must pay for 20% of covered services.

Supplemental insurance, such as Medigap, would likely cover at least a portion of those costs. But Medigap and similar policies can be expensive to buy.

When it comes to prescription drugs (Part D), there is no cap on out-of-pocket costs. Assuming that one’s Part D has a deductible, it may run as much as $445 this year.

 

What About Medicare Advantage? 

Medicare Advantage plans—which covers Part A, B and typically D—differ from original Medicare. Medicare Advantage plans may have a monthly premium in addition to what original Medicare beneficiaries pay. These plans also tend to have differing deductibles and copay amounts—all of which depend on the type of coverage.

Some Medicare Advantage plans have elected to waive some cost-sharing for the remainder of the COVID-19 pandemic.

Medicare Advantage plans also have yearly out-of-pocket limits. The limit depends on the plan, but cannot exceed $7,550 this year.

 

COVID-19 Expenses Covered by Medicare

  • COVID-19 lab tests – no out-of-pocket cost
  • FDA-authorized COVID-19 antibody lab tests
  • Monoclonal antibody treatment for COVID-19
  • COVID-19 vaccines – no out-of-pocket cost
  • MA plans may offer their subscribers extended benefits, such as meal delivery or medical transport services (depending on the plan)

Concerned about how you’ll pay for COVID-19 medical bills? You’re not alone. The good news is that our financial advisors can help you figure it out. Click here to make a no-obligation, free appointment to speak with one.

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