{"id":41480,"date":"2023-05-12T11:42:12","date_gmt":"2023-05-12T15:42:12","guid":{"rendered":"https:\/\/mtelehealth.com\/?p=41480"},"modified":"2023-05-12T11:42:12","modified_gmt":"2023-05-12T15:42:12","slug":"what-medicare-beneficiaries-need-to-know-about-the-end-of-the-covid-19-public-health-emergency-rules","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/what-medicare-beneficiaries-need-to-know-about-the-end-of-the-covid-19-public-health-emergency-rules\/","title":{"rendered":"What Medicare beneficiaries need to know about the end of the COVID-19 public health emergency rules"},"content":{"rendered":"\n\n\n<p>The end of the COVID-19 public health emergency on May 11 has created dizzying changes for Medicare beneficiaries.<\/p>\n\n\n\n<p>Whether Medicare will or won\u2019t cover certain health care costs may now depend on whether you are in Traditional Medicare or a private insurer\u2019s Medicare Advantage plan, want remote monitoring for a chronic condition, and need rehab in a skilled nursing facility.<\/p>\n\n\n\n<p>The Trump administration initially declared the coronavirus a public health emergency in January 2020. Although COVID-19 was the fourth leading cause of death in the United States last year and more than 1,000 Americans die from it weekly, the new phase of the pandemic has led the U.S. government to&nbsp;<a href=\"https:\/\/fortune.com\/well\/2023\/05\/11\/covid-19-public-health-emergency-end-what-it-means\/\" rel=\"noreferrer noopener\" target=\"_blank\">relax its health care rules<\/a>.<\/p>\n\n\n\n<p>Here\u2019s what Medicare beneficiaries need to know about their new world of health insurance coverage:<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-higher-costs-for-medicare-advantage-out-of-network-doctor-visits\"><strong>Higher costs for Medicare Advantage out-of-network doctor visits<\/strong><\/h2>\n\n\n\n<p>During the public health emergency,&nbsp;<a href=\"https:\/\/fortune.com\/well\/2023\/03\/25\/what-to-know-about-medicare-advantage-open-enrollment\/\" rel=\"noreferrer noopener\" target=\"_blank\">Medicare Advantage plans<\/a>&nbsp;weren\u2019t allowed to charge more if members saw out-of-network physicians. \u201cBut those protections will end, and people will once again either have to pay more or not have coverage depending on their Medicare Advantage plan,\u201d says Juliette Cubanski, the San Francisco-based deputy director of the Program on Medicare Policy at KFF, a health policy research and news nonprofit.<\/p>\n\n\n\n<p>\u201cIf people started seeing a provider who\u2019s not in their Medicare Advantage plan\u2019s network and expect to continue to see that provider, they may face the reality that it will come with a higher price tag,\u201d she adds.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-continued-coverage-for-telehealth-mostly\"><strong>Continued coverage for telehealth (mostly)<\/strong><\/h2>\n\n\n\n<p>\u201cThe good news is that Medicare beneficiaries receiving telehealth will be able to do so through at least December 31, 2024,\u201d says Erin Whaley, health sciences partner at the Troutman Pepper law firm in Richmond, Va.<\/p>\n\n\n\n<p>Telehealth is largely unaffected by the end of the public health emergency because of a 2023 law extending Medicare\u2019s telehealth coverage through next year. So, you\u2019ll still be covered for a telehealth appointment, including one with an audiologist, occupational therapist, physical therapist or clinical psychologist.<\/p>\n\n\n\n<p>But there are two exceptions.<\/p>\n\n\n\n<p>One is for remote monitoring for chronic and acute conditions. Medicare beneficiaries are now only covered for telehealth monitoring of, say, a continuous glucose monitor for diabetes if they are already patients of the doctor providing this care, notes Whaley.<\/p>\n\n\n\n<p>\u201cThat\u2019s changing back to the pre-pandemic rules, where you could only get remote monitoring if you were an \u2018established\u2019 patient,\u201d she says. If you don\u2019t have a doctor for remote monitoring, you now need to find one to become an established patient, she adds.<\/p>\n\n\n\n<p>The other exception: Medicare no longer pays for routine home care through telehealth under the program\u2019s hospice benefit, according to CMS.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-the-end-of-free-at-home-covid-19-tests\"><strong>The end of free at-home COVID-19 tests<\/strong><\/h2>\n\n\n\n<p>\u201cThe main area where people on Medicare are likely to notice changes is if they go to get COVID-19 tests from a pharmacy or do at-home testing,\u201d says Cubanski.<\/p>\n\n\n\n<p>Since April 2022, Medicare beneficiaries could get eight free at-home COVID-19 tests a month. Now, Medicare will no longer cover at-home tests for people in Traditional Medicare, Cubanski says. A KFF analysis found the average cost of an at-home rapid COVID-19 test is now $11.<\/p>\n\n\n\n<p>\u201cThe convenience of at-home testing has really enabled people to test whenever they want to get together with their friends or family and know\u2014with whatever certainty you get from the at-home test\u2014whether or not you are infectious and maybe potentially risking exposing other people in your life who may be immunocompromised or have other conditions that predispose them to serious illness if they get infected.\u201d<\/p>\n\n\n\n<p>Each Medicare Advantage plan, however, will decide whether to keep offering these tests for members. \u201cIt\u2019s not a requirement, it\u2019s an option,\u201d says Cubanski. \u201cI think CMS [the Centers for Medicare and Medicaid Services] is certainly encouraging Medicare Advantage plans to continue to offer this as a supplemental benefit. It seems reasonable to think that a lot of plans covering it as an over-the-counter benefit will continue to do so.\u201d<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-new-rules-for-covid-19-pcr-and-antigen-tests\"><strong>New rules for COVID-19 PCR and antigen tests<\/strong><\/h2>\n\n\n\n<p>Medicare will still cover COVID-19 PCR and antigen tests given in approved laboratories and ordered by doctors.<\/p>\n\n\n\n<p>People on Traditional Medicare still won\u2019t have to pay for these tests. But they may have to pay for the doctor visit resulting in the prescription for the test, Cubanski says.<\/p>\n\n\n\n<p>Some Medicare Advantage plans may charge members for PCR and antigen tests and associated doctor visits or require the tests be done by in-network doctors.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-no-changes-for-covid-19-vaccines\"><strong>No changes for COVID-19 vaccines<\/strong><\/h2>\n\n\n\n<p>COVID-19 vaccines will still generally be free to people on Traditional Medicare, as long as the U.S. government stockpile has them and your doctor takes Medicare. Medicare Advantage plans won\u2019t charge for COVID-19 vaccines either, if you go to one of their in-network providers.<\/p>\n\n\n\n<p>\u201cWhen the government supply of COVID-19 vaccines runs out and the supply shifts to the private sector, the beneficiary cost will still be zero,\u201d says Cubanski.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-paxlovid-free-for-now\"><strong>Paxlovid: free for now<\/strong><\/h2>\n\n\n\n<p>Paxlovid, an antiviral drug use to treat people with COVID-19 will still be free\u2014as long as the government\u2019s supply lasts.<\/p>\n\n\n\n<p>When the Paxlovid stockpile ends, Medicare beneficiaries with Part D Medicare prescription drug plans will be able to get the treatment for free through December 2024. But those without Part D plans may start owing co-pays for the treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-concern-about-the-three-day-rule\"><strong>Concern about \u2018the three-day rule\u2019<\/strong><\/h2>\n\n\n\n<p>Experts at LeadingAge, a group representing over 5,000 nonprofit aging services providers, say a big change for some beneficiaries with Traditional Medicare is the return of what\u2019s known as \u201cthe three-day rule.\u201d<\/p>\n\n\n\n<p>During the public health emergency, Medicare waived the rule that required people be admitted into hospitals for at least three consecutive days before Medicare would cover a subsequent stay in a skilled nursing facility for, say, rehab.<\/p>\n\n\n\n<p>The waiver, Whaley says, was partly to avoid overcrowding in hospitals during the pandemic. It sometimes helped Medicare beneficiaries with injuries from falls get rehab treatment in skilled nursing facilities.<\/p>\n\n\n\n<p>But the three-day rule is now back.<\/p>\n\n\n\n<p>As a result, \u201cyou could be paying fully out of pocket for care in a skilled nursing facility because you didn\u2019t meet the minimum stay requirement before you were discharged,\u201d says Cubanski. (Medicare Advantage members are excluded from the three-day rule if they go to in-network facilities.)<\/p>\n\n\n\n<p>The three required days in the hospital don\u2019t include days when a patient is in the medical center \u201cunder observation,\u201d but not technically admitted. \u201cThat\u2019s why it\u2019s really important for people to understand, when they\u2019re in the hospital, \u2018Is this day an observation day or an actual inpatient day?\u201d says Cubanski.<\/p>\n\n\n\n<p>Requiring a hospital stay of three days or longer before being transferred to a skilled rehab facility, critics say, delays necessary care and can lead to extra out-of-pocket costs for people in Medicare. LeadingAge says lengthening hospital stays can be challenging for older people, especially ones with cognitive impairments.<\/p>\n\n\n\n<p>The American Health Care Association\/National Center for Assisted Living told Skilled Nursing News in a statement: \u201cFor years we have advocated to eliminate this confusing policy barrier by recognizing observation stays as qualifying stays for the purposes of the three-day stay requirement or eliminating the three-day requirement all together.\u201d<\/p>\n\n\n\n<p>LeadingAge has urged the Department of Health and Human Services (HHS) to make permanent the waiver of the three-day requirement and Congress to end the requirement entirely.<\/p>\n\n\n\n<p>\u201cIn the more than half-century since the requirement was adopted, a growing body of evidence and experience has proven that automatically requiring a three-day inpatient hospital stay is unreasonable, unnecessary, irresponsible and inequitable,\u201d LeadingAge president and CEO Katie Smith Sloan said in a statement sent to Congress and HHS.<\/p>\n\n\n\n<p>The end of the three-day rule, some experts say, will lead some Medicare beneficiaries to go from the hospital to home care rehab, since Medicare often pays for that.<\/p>\n\n\n\n<p>This story was originally featured on&nbsp;<a href=\"https:\/\/fortune.com\/well\/2023\/05\/12\/medicare-beneficiaries-end-of-covid-19-emergency-rules\/\" rel=\"noreferrer noopener\" target=\"_blank\">Fortune.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The end of the COVID-19 public health emergency on May 11 has created dizzying changes [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":41481,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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