Does Medicare Coverage Apply to COVID-19 Treatment?

The federal government has announced that the treatment will be available with no cost-sharing for patients. Understand current Medicare coverage, and how it applies to COVID-19 treatment payments.

Money Talks News’s recent article entitled “Medicare to Cover New Coronavirus Treatment” says that treatments in settings such as a doctor’s office, nursing home, or infusion center will now be covered without cost-sharing for those with Medicare, the federal health insurance program for seniors and people with certain disabilities.

This COVID-19 coverage (which started on November 10) is for monoclonal antibody infusions in facilities where “safety precautions can be met,” according to the Centers for Medicare & Medicaid Services, or CMS.

This coverage includes having access to medications that can treat anaphylaxis and other severe infusion reactions.

The day before the CMS announcement, the FDA issued an emergency use authorization for an investigational monoclonal antibody therapy for the treatment of mild to moderate cases of COVID-19 in patients at high risk for becoming severely ill, and/or who are likely to require hospitalization. It’s called bamlanivimab.

The CMS announcement is the most recent expansion of Medicare coverage to help treat the disease.

Medicare and private insurance will also pay for any coronavirus vaccine that is approved early.

Medicare is a federal program that provides health insurance to Americans. It’s frequently called Original Medicare. It has two parts—Part A and Part B. Part A covers inpatient hospital and skilled nursing care, and Part B covers doctor visits and outpatient care.

Private Medicare plans are optional and provide more coverage. Medicare Advantage plans (also known as Part C) combine Part A and Part B coverage and may have drug coverage and other benefits you don’t receive with Original Medicare.

Medicare prescription drug plans (Part D) help pay for medications. Seniors can buy a standalone Part D plan or get a Medicare Advantage plan that includes drug coverage.

Medicare supplement insurance or “Medigap” helps pay some or all costs not paid by Original Medicare, such as deductibles, copays and coinsurance.

Reference: Money Talks News (Nov. 12, 2020) “Medicare to Cover New Coronavirus Treatment”

When Do We Need an Elder Law Attorney?

Kiplinger’s article “When Elder Care Requires Legal Advice” explains that this is when a lot of panicked calls are made to elder law attorneys. These elder law attorneys specialize in planning for the legal complications that can arise in old age. However, seldom do people think to consult one preemptively to avoid making that panicked phone call in the first place.

Elder law attorneys work in the best interests of the older person, although how that is accomplished may differ. If the senior is competent and contacts the attorney, it can be fairly straightforward. However, if an adult family member or friend is an agent or has power of attorney for an elderly person—and asks for help, the attorney is representing the agent. In any event, anyone who has power of attorney has a fiduciary responsibility to do what is best for the elderly person granting them that authority.

If a power of attorney isn’t in place and the elderly parent is incapable of giving it, the family is required to go to court to have someone appointed as a guardian, which can be a time-consuming option. If a parent is cognitively capable and doesn’t want help, there’s nothing an attorney can do about it.

Although state laws vary, elder law primarily concerns these topics:

  • The client’s wishes and health
  • Family dynamics; and
  • The client’s financial assets and income.

An elder law attorney will also make sure that all important documents are in place and up-to-date, according to state laws. This includes a will, a trust, a power of attorney and an advance directive that includes a health care proxy.

Elder law attorneys also help moderate tough decisions, like when family members can’t agree about how a loved one wanted to be buried.

In addition, elder care lawyers understand the complex laws for Medicaid and VA benefits. An elder care lawyer can speak to many other issues, ranging from long-term care insurance to capital gains taxes.

A key when meeting with an elder law attorney is that you feel comfortable, that you’re not rushed and that your questions are answered.

Reference: Kiplinger (Sep. 15, 2020) “When Elder Care Requires Legal Advice”