The COVID-19 public health emergency (PHE) ended on May 11, 2023. During the PHE, there were some changes to Medicare coverage that will no longer be in place.
Original Medicare covers COVID-19 testing with no cost-sharing (no deductible, coinsurance, or copayment) when the test is ordered by a physician or other health care practitioner. The two kinds of covered tests are:
- PCR tests, which identify genetic material
- Antigen tests, which are often called rapid tests
Original Medicare does not cover over-the-counter at-home tests as of May 11, 2023.
Medicare Advantage Plans must cover COVID-19 tests. However, there may be out-of-pocket costs as of May 11, 2023. Contact your plan to learn more about costs. Medicare Advantage Plans may also continue to cover over-the-counter at-home tests at no cost. Contact your plan to learn if this supplemental benefit is offered, and how to access it.
Original Medicare Part B covers COVID-19 vaccines and boosters, regardless of whether you have Original Medicare or a Medicare Advantage Plan. You pay nothing for the vaccine or booster.
Skilled nursing facility (SNF) care
Part A typically only covers skilled nursing facility care if you were formally admitted as an inpatient to a hospital for at least three consecutive days. During the PHE, Medicare removed the three-day hospital stay requirement if you were affected by the COVID-19 public health emergency. This change is no longer in place as of May 11, 2023.
Medicare also changed other SNF requirements. Typically, Part A covers up to 100 days of SNF care each benefit period. A benefit period begins when you are admitted to the hospital as an inpatient, or to a SNF, and it ends when you have been out of the SNF for at least 60 days in a row. After your benefit period has ended, you receive another 100 days of SNF care at the start of a new benefit period. During the PHE, if you were unable to end a benefit period and start a new one because of the public health emergency, you could get another 100 days of covered SNF care without having to begin a new benefit period. This change is no longer in place as of May 11, 2023.
Until December 31, 2024, Medicare covers telehealth visits whether you:
- Live in a rural or urban area
- Get the services at home or in health care settings
Medicare covers hospital and doctors’ office visits, mental health counseling, and other visits via telehealth. If you have a Medicare Advantage Plan, it must cover telehealth services as well. Contact your plan to learn about costs and coverage.
After December 31, 2024, coverage for telehealth benefits may be more limited.