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How will the end of the public health emergency affect Medicare enrollees?
The end of the public health emergency on May 11, 2023, will result in changes to Medicare's coverage of COVID-related healthcare services, COVID tests and vaccines and telehealth services.
To what extent does Medicare cover COVID vaccinations?
The number of doses of COVID-19 vaccine Medicare enrollees will receive varies based on medical history and the specific vaccines received.
Minneapolis, MN – Some of the health coverage and cost savings put in place during the COVID-19 pandemic are coming to an end. Medicareresources.org and healthinsurance.org are letting consumers know what changes to expect with the end of the public health emergency on May 11, 2023.
“Many people don’t realize their ability to access certain care at lower costs has been largely the result of the public health emergency,” said Dr. Tanya Feke, an analyst for medicareresources.org. “With the public health emergency coming to an end, it’s going to be an adjustment for consumers.”
The federal government expanded coverage for certain telehealth services, hospital care, and COVID-related testing and care under the public health emergency (PHE), beginning in January 2020. While some measures will continue or be phased out over the next few years, consumers will begin seeing changes to their coverage – and their share of costs – as early as May 12.
The end of the public health emergency will result in big changes for Medicare recipients, whether they have Original Medicare or a Medicare Advantage plan.
Changes to COVID-related Medicare benefits include:
“I expect these telehealth changes will be very disruptive,” Feke said. “The change in software use and audio-only access could result in a sharp drop-off in telehealth use overall.”
In general, Marketplace and employer-sponsored health plans already require their normal out-of-pocket costs for COVID treatments, and their telehealth coverage is not regulated to the extent that it is for Medicare. So the end of the PHE may not be as disruptive for consumers covered by these plans.
Here are the changes these consumers can expect:
“Some of the normal rules didn’t apply during the pandemic,” said Louise Norris, health policy analyst for healthinsurance.org. “After three years, it will be a bit of an adjustment for consumers, who may face higher costs for things like COVID testing.”
Even with the end of the PHE, consumers will continue to have access to free COVID-19 vaccines and boosters. That is true whether they have Original Medicare, a Medicare Advantage plan, a Marketplace plan, coverage through an employer, or Medicaid. (Grandfathered health plans, however, do not have to cover the full cost of vaccines). Consumers will need to comply with in-network restrictions to avoid costs, though.
Most consumers with a Marketplace plan or employer coverage will experience minimal or no changes to their telehealth access and coverage with the end of the PHE.
The end of the PHE will not have an immediate impact on Medicaid recipients. COVID vaccines will continue to be free under Medicaid. Testing and treatment for COVID will also continue to be covered by Medicaid at no cost, but only until the summer of 2024.
The PHE originally included a continuous coverage requirement that prevented states from disenrolling Medicaid patients. However, the federal spending bill passed in December of 2022 notified states that they could begin disenrollments as early as April 1, 2023. While no longer tied to the PHE, that policy change is significant as it is expected to result in the loss of Medicaid and Children’s Health Insurance (CHIP) coverage for up to 15 million people nationwide.
Medicareresources.org is one of the longest running online sources of in-depth information about Medicare. The site provides an overview of the basics of Medicare coverage options, enrollment and eligibility; coverage FAQs; state-specific Medicare information; and a glossary of Medicare terms. The medicareresources.org website is owned and operated by Healthinsurance.org, LLC.
Contact:
Amy Fletcher Faircloth, [email protected]