Medicare and Coronavirus – Update from Medicare.gov
Get a COVID-19 vaccine as soon as you can.
- Medicare covers the COVID-19 vaccine at no cost to you. Medicare covers the vaccine for anyone 5 and older who has Medicare due to their age, a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Be sure to bring your Medicare card.
- Medicare covers a COVID-19 vaccine booster shot at no cost to you. You can get a booster from the same COVID-19 vaccine that you originally got, or choose a different one.
- If you got a Pfizer or Moderna COVID-19 vaccine, you can get a booster shot at least 5 months after you complete your second dose of the Pfizer or Moderna COVID-19 vaccine series.
- If you got a Johnson & Johnson COVID-19 vaccine, you can get a booster shot at least 2 months after you got your first shot.
- Learn more about who should get a booster shot.
- If you’re immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases), Medicare will cover an additional dose of the COVID-19 vaccine, at least 28 days after a second dose, at no cost to you. Note: Don’t mix vaccines. If your first two doses were Pfizer, your third dose should also be Pfizer. If your first two doses were Moderna, your third dose should also be Moderna.
- COVID-19 vaccines are safe and effective. Get details about the vaccine.
- If you have Medicare and have a disability or face other challenges in getting to a location away from home for a vaccination, Medicare will pay a doctor or other care provider to give you the COVID-19 vaccine in your home. You may need to give them your Medicare Number for billing, but there’s still no cost to you for the vaccine and its administration. Get details about the vaccine at home.
Medicare wants to help protect you from COVID-19:
- Medicare covers items & services related to COVID-19
- If you paid to get a a COVID-19 vaccine
- Be alert for scammers trying to steal your Medicare Number
- How to stay up to date
Medicare covers items & services related to COVID-19
- FDA-authorized and FDA-approved COVID-19 vaccines. You pay no out-of-pocket costs.
- Lab tests for COVID-19. You pay no out-of-pocket costs.
- COVID-19 Over-the-Counter (OTC) tests—see section below for details.
- FDA-authorized COVID-19 antibody (or “serology”) tests if you were diagnosed with a known current or known prior COVID-19 infection or suspected current or suspected past COVID-19 infection.
- Monoclonal antibody treatments for COVID-19.
- All medically necessary hospitalizations. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. You’ll still pay for any hospital deductibles, copays, or coinsurances that apply.
- Expanded telehealth services during the Public Health Emergency.Note Military hospital ships and temporary military hospitals don’t charge Medicare or civilians for care. If you’re not sure whether the hospital will charge you, ask them.
- If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Many plans offer additional telehealth benefits and expanded benefits, like meal delivery or medical transport services. Check with your plan about your coverage and costs.
COVID-19 Over-the-Counter (OTC)
Currently, Original Medicare doesn’t pay for over-the-counter COVID-19 tests.
In early Spring 2022, people with Medicare will be able to go to a network of pharmacies and health care facilities to get up to 8 free, over-the-counter COVID-19 tests a month through Medicare. More information will be available in early Spring.
Medicare does cover COVID-19 tests you get from a laboratory, pharmacy, doctor, or hospital, and when a doctor or other authorized health care professional orders it. You can also get up to one lab-performed test a year without an order, at no cost to you.
Some Medicare Advantage Plans may cover and pay for at-home over-the-counter COVID-19 tests as an added benefit. Check with your plan to see if it will cover and pay for these tests.
For now, you can:
- Visit COVIDtests.gov to order 4 free at-home COVID-19 tests per household.
- Access low-to-no-cost COVID-19 tests through healthcare providers at over 20,000 free community-based testing sites nationwide.
If you paid to get a COVID-19 vaccine
When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.
If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you:
- Check the receipts and statements you get from your provider for any mistakes.
- Call your provider’s office to ask about any charges you think are incorrect. The person you speak to may help you better understand the services you got, or realize they made a billing error.
- If you have Original Medicare, review your “Medicare Summary Notice” for errors. Report anything suspicious to Medicare by calling 1-800-MEDICARE (1-800-633-4227).
- If you have other coverage like a Medicare Advantage Plan, review your “Explanation of Benefits.” Report anything suspicious to your insurer.
If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of Health and Human Services by calling 1-800-HHS-TIPS or visiting TIPS.HHS.GOV.
Be alert for scammers trying to steal your Medicare Number
Medicare covers the vaccine at no cost to you, so if anyone asks you for your Medicare Number to get access to the vaccine, you can bet it’s a scam.
Here’s what to know:
- You can’t pay to put your name on a list to get the vaccine.
- You can’t pay to get access to a vaccine.
- Don’t share your personal or financial information if someone calls, texts, or emails you promising access to the vaccine for a fee.
Scammers may use the COVID-19 public health emergency to take advantage of people while they’re distracted. As always, guard your Medicare card like a credit card, check Medicare claims summary forms for errors. If someone calls asking for your Medicare Number, hang up.
How to stay up to date
- CDC.gov/coronavirus has the latest public health and safety information from CDC and for the overarching medical and health provider community on COVID-19.
- USA.gov has the latest information about what the U.S. Government is doing in response to COVID-19.