With news about the COVID-19 pandemic changing frequently, understanding how Medicare insurance recipients should approach testing for the virus as a beneficiary is more important than ever.

Who Should Get Tested for COVID-19?

If testing resources are limited in your area, you may be restricted by local policy as to whether or not you should be tested for COVID-19. A high, persistent fever, respiratory distress and recent contact with a person who has been confirmed to have COVID-19 are the most common requirements for areas where tests or facilities and laboratories to process those tests are overwhelmed or limited the most.

Where resources are limited, the CDC advises the following method of prioritizing tests:

  • Priority 1: symptomatic hospitalized patients and health care facility workers
  • Priority 2: symptomatic patients in long-term care facilities, people who are 65 and older, people with preexisting health conditions and emergency first responders
  • Priority 3: symptomatic people who work in critical infrastructure positions and anyone else who displays symptoms but may not fit above criteria
  • Non-Priority: individuals without any symptoms

States are not required to follow these guidelines and many regions may adjust these guidelines as their resources allow. Generally speaking, if you have no symptoms of illness, getting tested in a resource-limited area is not advised. If tests are readily available in your area and you’re concerned you may have been exposed and are asymptomatic, you may still be able to get tested for COVID-19.

Medicare Coverage for a Coronavirus (COVID-19) Test                              

In order to ensure any test you receive is covered by Medicare, you should talk to your doctor about your need for that test. They can help you navigate the appropriate set of steps you should take to make sure your diagnostic procedure remains covered. Most testing facilities require you to have an order form a physician in order for you to get the COVID-19 test.

In the case of COVID-19, there is no copay or deductible to meet before Medicare coverage of the cost of the test kicks in. Medicare may require that your physician perform the test or provide documentation that supports testing via another provider. You may also be subject to other regional restrictions about accessing tests.

For the COVID-19 pandemic, Medicare insurance policy has eased rules around telehealth services. These are health care services that are provided over the phone or via web cam and computer or phone. This can help Medicare recipients approach their primary care physicians about testing for COVID-19 without the need to leave their home.

The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) remain the most direct resources for changes made for Medicare recipients in response to the COVID-19 pandemic. For more specific details regarding testing and Medicare coverage, please contact your physician, or for more general information, visit Medicare or the CDC directly.

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