understanding medicare in the months of covid

Medicare, a program that has grown and evolved over time, has always been a challenge to fully understand, but in the current era of uncertainty and day-by-day changes, keeping up can feel impossible. The good news is that there are sources you can use to find up-to-date information and assistance from home.

[On March 27, 2020, President Trump signed the COVID- related CARES Act with several Medicare-related provisions including: (1) expansion of telehealth services that usually require in-person visits with health care providers; (2) allowing physicians assistants, nurse practitioners and other professionals to order home health services for beneficiaries; (3) allowing up to 90-day fills of prescription medication if requested by a beneficiary during the emergency period; along with other provisions.]

Senior Benefits Individual Counseling
Before the PAUSE order, a number of Westchester libraries were home to weekly drop-in Medicare counseling sessions. Patrons could come in, ask questions about Medicare, compare various plans and, hopefully, leave with an idea of how to get the most bang for their buck out of their coverage. These Senior Benefits Individual Counseling (SBIC) sites are an example of a volunteer-led State Health Insurance Assistance Program (SHIP). Volunteer counselors at the SBICs – fellow seniors from around Westchester – provide objective Medicare information, without the need to advocate a certain plan or style of Medicare over another. Another purpose of the SBIC program is to provide referrals to local services and supports. Volunteers are acquainted with county organizations that serve seniors whether they are looking for legal help, financial aid, social support, and more.

While drop-in counseling sites will remain closed until a level of safety can be assured for the SBIC volunteers and the people they serve,  there is still a way to access counseling. The SBIC Helpline provides remote support for those in need of Medicare information. The Helpline can be reached by calling 914-231-3260 or by emailing SBICS@wlsmail.org. Volunteer coordinators monitor the helpline seven days a week. Callers should leave a name, question, and preferred contact method, and counselors will respond.

[COVID-related Medicare and Medicaid policy changes include: (1) expanding the destinations to which ambulance services can be covered by Medicare; (2) allowing coverage for home testing for COVID-19; (3) someone can be “homebound” in order to qualify for home health coverage if a physician determines that it is contraindicated for the Medicare beneficiary to leave home – or due to suspected or confirmed COVID-19, though the homebound requirement was not waived.]

Department of Senior Programs and Services
The Westchester County Department of Senior Programs and Services (DSPS) maintains two helplines to help seniors connect to needed services. They have their own Medicare Information Line (914-813-6300), whereby county employees can assist with Medicare applications. This resource is especially suitable for seniors who do not have their own computer or internet access, as DSPS staff will work with callers over the phone to fill out an online Medicare application.

Westchester residents can also call the General Helpline (914-813-6300) or the Elder Abuse Helpline (914-813-6436) to be connected with non-Medicare information and services they are seeking.

[Coronavirus testing is covered under Medicare Part B for testing provided after February 4, 2020. If a coronavirus vaccine is developed, it will also be covered under Medicare Part B.  If you have a Medicare Advantage Plan, contact your plan to learn about its cost and coverage rules.]

Medicare.gov, Medicare Rights Center, Center for Medicare Advocacy
There are other places to find current information on Medicare:
Medicare.gov offers information about COVID-19 and what Medicare can cover.
Medicare Rights Center has also been keeping an updated blog post of Medicare-covered services related to coronavirus, and how to access those services under current circumstances.
Center for Medicare Advocacy provides information on how both Medicare and Medicaid are attempting to address the pandemic, including information on skilled nursing facility coverage.

These sources are rich with information – including changes responsive to COVID-19 – which can make them difficult to understand. If you need help understanding any of the information you find, reach out the the SBIC and DSPS helplines.

[Medicare Part A generally only covers Skilled Nursing Facility care if someone was a hospital inpatient for three days in a row before entering the SNF: the three-day qualifying hospital stay. Medicare has removed the three-day qualifying hospital stay requirement during this time for beneficiaries who experience dislocations or are otherwise affected by the coronavirus health crisis.]

For more information on anything discussed here or to find out more about the SBIC sites, email Krishna Horrigan, WLS Outreach, at khorrigan@wlsmail.org

Latest posts by WSV (see all)