FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

Source:  Juliette Cubanski and Meredith Freed  Published: Mar 30, 2020/https://www.kff.org/

More than 60 million people ages 65 and older and younger adults with long-term disabilities are covered by Medicare. Due to their older age and higher likelihood of having serious medical conditions than younger adults, virtually all Medicare beneficiaries are at greater risk of becoming seriously ill if they are infected with the new coronavirus that causes COVID-19. COVID-19 is an infectious respiratory disease, which currently has no vaccine or cure. Diagnosis of COVID-19 is confirmed through testing, and treatment varies based on the severity of illness.

These FAQs review current policies for Medicare coverage and costs associated with testing and treatment for COVID-19, including changes adopted in three recent bills: the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, enacted on March 6, 2020 (Public Law 116-123); the Families First Coronavirus Response Act, enacted on March 18, 2020 (Public Law 116-127); and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020 (Public Law 116-136).

Does Medicare cover testing for COVID-19?

Yes, testing for COVID-19 is covered under Medicare Part B when it is ordered by a doctor or another health care provider that accepts Medicare, and if the test was ordered after February 4, 2020. Medicare Advantage plans are required to cover all Medicare Part A and Part B services, including COVID-19 testing.

How much do Medicare beneficiaries pay for COVID-19 testing?

Medicare beneficiaries who get tested for COVID-19 are not required to pay the Part B deductible or any coinsurance for this test, because clinical diagnostic laboratory tests are covered under traditional Medicare at no cost sharing. (Under traditional Medicare, beneficiaries typically face a $198 deductible for Part B services and coinsurance of 20 percent.) A provision in the Families First Coronavirus Response Act also eliminates beneficiary cost sharing for COVID-19 testing-related services, including the associated physician visit or other outpatient visit (such as hospital observation, E-visit, or emergency department services). A testing-related service is a medical visit furnished during the emergency period that results in ordering or administering the test. The law also eliminates cost sharing for Medicare Advantage enrollees for both the COVID-19 test and testing-related services, and prohibits the use of prior authorization or other utilization management requirements for these services.

Read the full article here

Telehealth keeping patients and providers connected during coronavirus pandemic

ST. JOSEPH COUNTY, Ind. (WNDU) The coronavirus pandemic is changing the way we interact with each other by the day.

More social distancing means physical and behavioral health care providers are finding new ways to get closer to their patients.

16 News Now learned how telehealth is making that easier.

It’s just like the name sounds, healthcare over the phone or internet. Telehealth is now taking center stage during the coronavirus pandemic as patients look to stay connected to their providers.

“People in mental health crises could increase due to the isolation,” said Oaklawn Adult and Addiction Services Vice President John Horsley

That’s one thing Horsley says Telehealth will be able to help with when continuing services for clients at home.

“Medicaid and Medicare have really loosened their guidelines during this crisis which has been very helpful to people. In terms of accessing care,” he said.

Those Medicaid and Medicare changes happened last week, allowing telemedicine and telephone options for most health care and mental health interactions.

UHC Renew Active – Update through COVID-19

In rapid response to gyms temporary closing due to COVID-19, Renew Active has enhanced its offering to include Fitbit Premium, as well as a “Staycation” feature with our cognitive partner, AARP Staying Sharp.

Fitbit Premium is now available to take advantage of for all members with Renew Active when they join the Fitbit Community for Renew Active (screenshot below). Fitbit Premium offers premium content and thousands of workout videos for all levels and intensity. The premium content and workout videos include;

  • A vast selection of yoga, weight training, low impact and equipment optional workout videos
  • Guided programs
  • Advanced sleep tools
  • Personalized insights
  • Mindfulness sessions 

Please note a Fitbit device is not required to access these workout videos.

In addition to Fitbit Premium, AARP Staying Sharp, our cognitive partner, launched a Staycation tile on their website. Here Renew Active members can access various content, including 17 quick in-home workout videos for members to stay active while in their home.

Additional information:

  • Member access: For access to the Fitbit Community and/or AARP Staying Sharp, Renew Active members can visit the Health and Wellness tab in their portal and begin the process of either joining the Fitbit group or registering on AARP Staying Sharp.
  • Renew Active Fitbit Community: Digital community where members can engage in health & wellness discussions and participate in step challenges with other Renew Active members
  • AARP Staying Sharp: Members can engage in a brain-health assessment, articles, recipes and even several short exercise videos. The videos vary between stretching, showcasing different types of yoga poses and strength exercises.
  • Many of our gym partners are offering digital classes and workouts to members during the time of their closure.



Wednesday, March 25, 2020

Open Payments COVID-19 Announcement

Open Payments COVID-19 Announcement

CMS is aware that the COVID-19 pandemic may impact some reporting entities and may affect their ability to submit records to the Open Payments Program on or before March 31st 2020.

CMS does not have the authority to waive the statutorily mandated requirement that Open Payments reporting be completed by the 90th day of the calendar year (see 42 U.S.C. § 1320a–7h(a)(1)(A) and 42 U.S.C § 1320a–7h(a)(2)) or to postpone the publication deadline of June 30 (42 U.S.C § 1320a–7h(c)(1)(C)). As such, CMS is unable to extend the submission window past the March 31st deadline.

However, CMS is sensitive to the challenges caused by the pandemic and will consider the impact that these circumstances have on reporting entities’ ability to report in a timely, accurate, and complete manner.

CMS will exercise enforcement discretion with respect to submissions completed after the statutory deadline due to circumstances beyond the reporting entity’s control associated with the pandemic. In an assumptions statement, you may explain your organization’s reporting methodologies or reasons for unusual or partial submissions.

If the pandemic has impacted your reporting processes, please include the phrase “COVID-19 Impact” in your assumptions statement alongside the explanation of the circumstances and, if applicable, include reference to any related help desk ticket numbers.

Questions—Contact Live Help Desk

Need help or have more questions? Contact the Open Payments Help Desk at openpayments@cms.hhs.gov or call 1-855-326-8366 (TTY Line: 1-844-649-2766).The Help Desk is available Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays.

The Help Desk refers media inquiries to CMS’ Press Office for response.

Aetna – COVID-19 Update

Aetna:  March 26, 2020:  Steps we’re taking to keep members safe:

  • To help prevent the spread of the coronavirus, known as COVID-19, we are cancelling all in person group member meetings and sales events at all venues, including those at retail locations. 
  • Sales events: If you have a filed a sales event with Aetna, we have canceled your event. CMS requirements for canceled events still apply. Please contact your Broker Manager if you have any questions about CMS requirements for cancellations.  
  • Member meetings: Please note that we will contact all members who RSVP’d for a meeting, by phone or email, to let them know about the cancellation. 

IMPORTANT: We highly recommend avoiding face-to-face contact with your clients. Instead of meeting with them in person, we encourage you to use our remote-selling tools (e-kits and RATE) to engage your clients electronically. 

Read the full update:

COVID-19 update_broker communication (March 19) FINAL

UHC’s New Base Contract Requires Agent & Agencies Signature- Please Read!

UHC’s New Base Contract Requiring Agent/Agency Signature

March 25, 2020

Beginning April 2, 2020, and continuing through May, UnitedHealthcare will begin sending new base contracts in an email from UnitedHealthcare Medicare Solutions Contracting. The new consolidated contract incorporates all contract changes incorporated in recent years by amendments, and contains minor changes to clarify terms.

Please look for an email from UnitedHealthcare Medicare Solutions Contracting and review and sign your new contract using DocuSign® within 30 days of receipt. Once you have completed the re-contracting process you will receive a confirmation email.


Remember to check your spam folder throughout April and May if you do not see an email with the new contract.

For more information and assistance with reviewing and signing the new contract please review the attached Job Aid and FAQ

TIPS – Medicare Phone Sales

Now more than ever, people want Medicare insurance solutions that provide peace of mind. When you’re unable to meet with a client in person, you can often help them get the coverage they need by phone. These simple tips and guidelines are designed to help you be more successful.

TIPS_Medicare_PhoneSales_3-24-20 CSM

TIPS – Handling Objections – Medicare

The biggest difference between in-person and telephonic sales is understanding how to handle objections in an effective manner. Here are a few tips that can be helpful to uncover and address objections.

TIPS_HandlingObjections MEDICARE_3-24-20 CSM

More Medicare Center Webinars!

Sign up for one of our webinars below:

Thursday March 26th at 2:00 PM EST

Tuesday March 31 at 2:00 PM EST

Thursday April 2 at 2:00 PM EST

Tuesday April 7 at 11:00 AM EST

Register HERE*

*click the drop down box for the demo date of your choice

MMO Broker Update – Telehealth/Telemedicine Coverage

Important Clarifications on Telehealth (Telemedicine) Coverage
Date: March 24, 2020
Category: News
Applies to: All

In efforts to help slow the spread of the coronavirus disease known as COVID-19, health professionals and their patients may turn more frequently to the use of telehealth (telemedicine) visits. Please review the summaries below: to better understand the coverage for these services.

Telehealth (telemedicine) visits (covered by all plans)

  • Telehealth (telemedicine) visits are primarily scheduled visits between patients and healthcare providers with an established relationship, and may be handled by computer, tablet or smartphone.
  • Telehealth (telemedicine) visits are for patients needing routine care for chronic or general health conditions. They are covered just like any other medically necessary office visit.
  • They are billed with office visit codes; modifiers are not required.
  • Behavioral health visits are included.

On-demand virtual visits (covered by most plans)

  • On-demand virtual visits are a subset of telehealth (telemedicine). These types of visits typically include 24/7 virtual access to licensed healthcare professionals with whom the patients do not have an established relationship.
  • They are similar to visits to an urgent care facility and are typically needed due to an acute health issue.
  • Visits are typically covered like primary care provider visits unless otherwise specified.
  • Behavioral health visits are not covered as on-demand virtual visits.
  • Examples of plan-specific covered on-demand virtual visit providers include the Cleveland Clinic’s Express Care online services and Teladoc.

If you have any questions about telehealth (telemedicine) benefits, please contact your Cornerstone Senior Marketing Representative