Medicare Beneficiaries Infected with Coronavirus may get Stunned due to Healthcare Price

Medicare beneficiaries are having scary times now. The 62 million Americans enrolled in Medicare are mostly of age 65 or older or younger citizens with disabilities. These sections of people have a greater health risk due to Coronavirus. Although Congress and regulators have eliminated out-of-pocket costs for testing and have taken vital steps to improve healthcare access, still the virus treatment will pose a bigger cost concern for a majority of them.

People seem to be in a state of anxiety and shock, especially with the whole thing moving so quickly that the treatment cost has not yet sunk with the people. Only a few Medicare beneficiaries have additional health insurance to cover the out-of-pocket costs of Medicare like copays, and deductibles and the rest have to pay more for hospital stays and various medical services. Though majority of people recover from the Coronavirus without requiring significant care, the costs that could come if treatment is needed is a major concern for people.

This amount will cover the first 60 days per benefit period Around 37.5 million Medicare beneficiaries opt for basic or Original Medicare, out of which many of them have additional coverage with plans like Medicaid or Medigap. Original Medicare comprising of Part A, hospital coverage and Part B, outpatient care, has no cap on out-of-pocket costs. So if people don’t have additional coverage beyond Original Medicare, which is the case with 6.1 million beneficiaries, then these people will need to pay a $1,408 as Part A deductible for a hospital stay. Beyond that people have to pay daily copays of $352 up to the 90th day. Anything above this comes from “lifetime reserve” days at a rate of $704 daily. The coronavirus patients who get moved to a skilled nursing facility don’t have to pay a copay for the first 20 days and after that it is $176.

Medicare Part B comprising of medical services like doctor’s visits has a $198 deductible, and beneficiaries are generally required to pay 20% of the covered services. However, for beneficiaries having a Medigap plan, most of these costs either fully or partially would be covered. People must know that Medigap plans have their own enrollment rules and its access is limited. Besides, these plans can cost several hundred dollars a month.

Meanwhile, even Medicare Part D or prescription drug price also has no cap on out-of-pocket spending and therefore, the medicine cost will depend on the coverage. People having a deductible with their plan can have a deductible of up to $435.

Americans should know that the $2 trillion coronavirus relief package signed into law on 27th March 2020 requires Part D plans with quantity limits so that it allows 90-day medication supplies.

Around 24 million Medicare beneficiaries get Part A and Part B through an Advantage Plan that also includes prescription drug coverage. These plans may or may not have a monthly premium and beneficiaries need to only pay for basic Medicare. The Advantage plans may also have different deductibles and copays and the amount can vary from plan to plan.

There is no certainty about the hospital stay duration for the treatment of coronavirus but it is certain that for the longer stay, the Advantage plan enrollees have to pay more compared to enrollees of Original Medicare.

However, very few data are available for coronavirus treatment cost or hospital stay duration in the U.S. but as per a group of researchers, the average hospital stay duration in Wuhan, China for patients who recovered was 10 days.

Medicare Advantage Plans operating in states with an emergency declaration are instructed by regulators to cover services at out-of-network facilities and charge the in-network price.

However, some of the insurance companies have implemented a change in the Advantage plans like waiving of certain pre authorization requirements or expanding the telehealth services. This is done to expand access to care for beneficiaries and on 29th March 2020 tow of the largest insurers of the U.S. said that they are waiving even treatment costs for the patients.