If you’re among those seeking COVID-19 treatment using Medicare or an ACA-compliant plan you might be in for a surprise or two. So says Jae Oh, author of Maximize Your Medicare.
First, though, Oh notes that Medicare and ACA-compliant plans are covering COVID-19 testing without charge.
“This is a welcome relief to many,” Oh said. “When we get widespread testing available in the country, then that will be at no cost from there.”
According to Oh, there is, however, a slight difference for Medicare enrollees who also have a Medicare Supplement Insurance, known as Medigap.
According to Medicare.gov, Medigap helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medigap policy can help pay some of the remaining health care costs, such as copayments, coinsurance, and deductibles.
The annual deductible for all Medicare Part B beneficiaries is $198 in 2020. But Medicare beneficiaries who also have a Medigap supplemental insurance policy typically don’t have to pay that deductible.
As for beneficiaries enrolled in a Medicare Advantage plan, Oh says each insurer gets to decides whether to cover the cost of a COVID-19 test.
“I don't mean to alarm persons, but I just wanted to draw the slight distinction, which means that the Medicare advantage carrier is actually going to be assessing what that charge would be,” Oh said.
Oh also noted that under Medicare advantage, if there's a related illness or if there's another illness that was not COVID-related that would subject a person to the normal Medicare Advantage payment schedule. “You would be responsible for the costs as detailed in your Medicare Advantage policy,” he said.