The End of the COVID-19 Emergency: A Medicare Customer Question

What You Need to Know

For most clients, vaccines are still available without cost-sharing.
Lab tests ordered by doctors will usually be covered without cost-sharing.
Tests purchased without a prescription may not be covered at all.

The federal government’s declared COVID-19 public health state of emergency finally came to an end on May 11, as weekly hospitalizations due to the virus are now at their lowest level since the pandemic.

The U.S. Department of Health and Human Services has issued a fact sheet with an update on the flexibilities offered during the COVID-19 state of emergency and how Americans will be affected now that the emergency is over.

Some of the changes could lead to clients facing the return of out-of-pocket costs.

The Question:

What does the end of the COVID-19 public health emergency mean for Medicare patients?

The Answer:

Here a look at how the conclusion of the public health emergency, or PHE, could affect your clients’ Medicare coverage.

The major telehealth access improvements will not be affected right away.

During the pandemic, Medicare recipients, especially those in rural areas who had difficulty accessing care, relied on telehealth services to obtain the care they needed.

These same Medicare telehealth flexibilities will continue through December 2024.

Most Medicare recipients can get COVID-19 vaccines without paying cost-sharing amounts.

Clients with Original Medicare coverage can get their vaccines without facing out-of-pocket costs as long as their health care providers accept assignment for giving the shots.

Clients with Medicare Advantage plans need to contact their plan representative to see what’s covered.

However, most Medicare Advantage beneficiaries will be able to get their COVID-19 shot for free as long as the service is obtained through an in-network provider.

Coverage for COVID-19 testing will change.

Over-the Counter Tests