Vaccines are getting increasingly more available. Are you wondering how it will be coverage if you have Medicare? Administration and vaccine cost are covered by Part B of Medicare.
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| Note |
| Medicare Advantage Plans can’t charge copayments, deductibles, or coinsurance for clinical lab tests to detect or diagnose COVID-19. |
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WASHINGTON (AP) — Federal health officials Wednesday issued insurance coverage rules designed to deliver on the promise that every American will have access to free COVID-19 vaccines when they are approved.
The regulations from the Centers for Medicare and Medicaid Services, or CMS, will also increase what Medicare pays hospitals for COVID-19 treatments. The changes arrive at a time when coronavirus infections are rising in much of the country, signaling a third wave that could eclipse the number of cases seen earlier this year.
Congress and President Donald Trump have already enacted legislation that calls for vaccines to be free, but the new rules were needed to align that policy with the many arcane payment requirements for public and private insurance
“CMS is acting now to remove bureaucratic barriers while ensuring that states, providers and health plans have the information and direction they need to ensure broad vaccine access and coverage for all Americans,” agency head Seema Verma said in a statement.
The rules aim to resolve potential legal issues over whether Medicare could cover a vaccine that receives “emergency use authorization” from the Food and Drug Administration. That’s a step short of full approval, and questions arose about whether Medicare could pay under its standard coverage policies.
Under Wednesday’s announcement:
— Seniors with traditional Medicare will pay nothing for COVID-19 vaccines, and any copays and deductibles are waived.
— The government will pay private Medicare Advantage plans to administer the vaccine to seniors. Enrollees will not be charged.
— Workplace and individual health insurance plans will cover the COVID-19 vaccine as a preventive service, with no cost sharing. The requirement applies to the vast majority of private plans, which are mandated to cover approved preventive care under the Obama-era Affordable Care Act — even as the Trump administration is trying to overturn that law at the Supreme Court.
— State Medicaid and Children’s Health Insurance plans will have to provide vaccines for free for the duration of the coronavirus public health emergency.
— Doctors, clinics and hospitals vaccinating uninsured people will be able to get paid through a federal fund set up to assist health care providers under financial stress.
The regulations take effect immediately.
A White House-backed initiative called “Operation Warp Speed” seeks to have a vaccine ready for distribution in the coming months. The government is spending billions of dollars to manufacture vaccines even before they receive FDA approval, thereby cutting the timeline for delivery. Officials at the FDA have pledged that the program will not interfere with their own science-based decisions. Vaccines that do not meet the test for approval would be discarded.
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MONITORING EMPLOYEE HEALTH
How to stay safe and monitor employee health while also abiding by: EEOC/ADA regulations (equal employment opportunity/American with disability act)
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How to stay safe and monitor employee health while also abiding by: CDC* guidelines (*Center for Disease Control and Prevention)
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How to stay safe and monitor employee health while also abiding by: OSHA* regulations (*Occupational Health Act of 1970)
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How to stay safe and monitor employee health while also abiding by: HIPAA Privacy & Security
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During the COVID-19 crisis, many people may have to change their status. Different events can trigger a Special Enrollment Period (SEP) for individual coverage. While much of the current attention is focused on COVID-19-related income changes, even a birth or a move will trigger an SEP as well.
See attached document.
Special Enrollment Chart
You may already be taking steps to protect your health during the COVID-19 emergency. Be sure to also protect your identity from scammers by guarding your Medicare Number.
It’s easy to get distracted and let your guard down during these uncertain times. Scammers may try to steal your Medicare Number. They might lie about sending you Coronavirus vaccines, tests, masks, or other items in exchange for your Medicare Number or personal information.
Protect yourself from scams:
Visit Medicare.gov/fraud for more information on protecting yourself from fraud and reporting suspected fraud.
Sincerely,
| The Medicare TeamNote: You can learn more about COVID-19 and your Medicare coverage on Medicare.gov. |
If benefits are needed. See the reference below.
Under the guidance, federal law permits significant flexibility for states to amend their laws to provide unemployment insurance benefits in multiple scenarios related to COVID-19. For example, federal law allows states to pay benefits where:
In addition, federal law does not require an employee to quit in order to receive benefits due to the impact of COVID-19.
For more information, visit https://www.dol.gov/coronavirus
For more information, visit https://myleavebenefits.nj.gov/worker/maternity/
Below, you can find a Q & A from the Centers for Disease Control & Prevention.
Find out more at https://www.cdc.gov/coronavirus/2019-ncov/index.html
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