FOR IMMEDIATE RELEASE
Medicare Coverage for COVID-19 Testing and Related Medical Claims – Does your retiree health benefit plan cover Coronavirus?
Newport, RI – We understand there is a lot of anxiety and unknowns regarding the Coronavirus outbreak across the United States. Since KTP focuses on Medicare retiree health plans and the virus is particularly dangerous for members of this group, we wanted to provide a little clarification on what is covered, what might not be, and the associated costs.
Testing for the Coronavirus will be covered 100% by the Centers for Disease Control and Prevention (CDC). The CDC may still bill your insurance plan so people will need their insurance card but they won’t be responsible for any co-pay or out of pocket costs.
For individuals with Medicare, the Federal government will waive all out of pocket costs to treat the Coronavirus. That includes doctor visits, hospitalizations, prescription drugs, etc.
But after the initial test, medical care for active employees and early (pre-Medicare) retirees may or may not be covered by your plan. With an insured private plan you’re covered.
Where it gets less clear and more complex is with large employers that are self-insured. The cost of medical care, including doctor visits and hospital stays, depends on the specific benefits offered in each plan. The costs of these benefits will be borne by the plan sponsor and co-pays or co-insurance for individuals will apply unless waived by the plan sponsor. These total costs could be astronomical.
We are advising our clients to cancel all retiree meetings and gatherings of any size until further notice and guidance from the Federal government.