How Will Medicare and Health Insurance Cover Coronavirus for Seniors and Diabetics?

Fran
Mary Kate Morrow
March 24, 2020

Seniors and people with serious chronic medical conditions including diabetes have a higher risk of developing serious symptoms and dying from the coronavirus than the general population. Seniors over the age of 80 have a 21.9% chance of dying as a result of contracting the coronavirus.

With public health officials anticipating potentially millions of people requiring hospitalization for coronavirus, seniors and diabetics need to make sure they have the best coverage possible. Seniors should consider purchasing a Medicare Advantage plan or Medicare supplement insurance to help with out-of-pocket coronavirus related expenses.

More than half of Americans are at risk of being unemployed or underemployed because of the coronavirus pandemic. Diabetics who have lost their job as a result of the pandemic can enroll in a health plan outside the open enrollment period.

How Will Medicare Cover Coronavirus?

Medicare is rapidly changing its policies to accommodate seniors who are contracting the coronavirus. Coronavirus testing will be covered by Medicare and Medicaid as a diagnostic test and essential health benefit. If the coronavirus test was performed on or after February 4, 2020, you are covered.

Medicare covers all medically necessary hospitalizations. You are also covered if you contract the coronavirus during hospitalization and need to stay in the hospital under quarantine. There is currently no vaccine for the coronavirus, but if one becomes available it will be covered by Medicare Prescription Drug Plans (Part D).

Medicare is temporarily offering telehealth appointments during the coronavirus pandemic. Medicare pays the same amount for telehealth services as it would for in-person services. Telehealth provisions help avoid filling doctors’ offices with infected patients and further spreading the coronavirus. Virtual visits connect you with your providers from the safety of your home.

You can access a wide range of medical professionals through telehealth appointments, including doctors, nurse practitioners, clinical psychologists and social workers. Telehealth covers regular office visits, preventative health screenings and mental health counseling.

Using telehealth should provide fast care, decrease the risk of exposure and allow experts access to patients in a wider geographic area. Medicare will also cover for you to communicate with your doctors through an online patient portal. You must initiate and provide consent for both telehealth appointments and online patient portal communications.

Many Medicare participants are subject to a $1,408 deductible, with coinsurance kicking in after the second month starting at $352 and gradually increasing over time. You are still liable for deductibles and coinsurance. There may be some flexibility for healthcare providers to reduce or waive cost-sharing costs for telehealth visits.

Considering the high-risk demographic of elderly people, Medicare recipients may want to consider buying Medicare supplement insurance for out of pocket costs, or a Medicare Advantage plan as an alternative to original Medicare.

How Will Standard Health Insurance Cover Coronavirus?

Standard health insurance policies have some coverage for coronavirus treatment. The coronavirus is being treated by most health insurance companies like any other virus. Unfortunately, this also means that consumers will still be financially responsible for some of their coronavirus treatment costs. There are no specific restrictions or limitations for coronavirus coverage. Insurers have not waived out-of-pocket expenses, including hospitalizations, during the pandemic. The average deductible amount for single coverage in 2019 was $1,655. More than 25% of employer-insured workers paid a deductible of $2,000 or more. If you receive out-of-network care, you could be personally responsible for a very high medical bill.

Nearly 1 in 3 American families decided not to seek medical care during the past year because of out-of-pocket expenses. This is a huge problem during a pandemic, as people are less likely to seek out and receive appropriate treatment. If you are one of the 60% of Americans who lack the savings to pay for an unexpected $1,000 deductible, you may want to consider a health insurance plan with lower deductibles.

Many health insurance companies are waiving the charges for coronavirus tests. Some are increasing telemedicine appointments and virtual care. If you are hospitalized or quarantined at a medical facility, your insurance should cover it like any other inpatient stay. Experimental or alternative treatments will likely not be covered by your health insurance.

If you self-quarantine at your home, your plan should cover the medical care you receive at your home from a licensed medical professional. Your health insurance plan will not pay for lost income while you are away from work.

You should be especially mindful of your health insurance coverage if you are diabetic because you are at a high risk of developing more serious symptoms and complications from the coronavirus. Check ahead of time with your health insurance company to find out what expenses you may be responsible for.

What Is The Correlation Between Diabetes and Coronavirus?

In general, diabetes patients are more susceptible to viral infections and tend to have more serious health outcomes than the general population. Diabetes impacts your immune system which may result in decreased immune system response to the coronavirus. Researchers in China have documented more hospitalizations and higher mortality rates in their diabetic coronavirus patients.

Viral infections can increase inflammation in people with diabetes and increase the risk of diabetic ketoacidosis (DKA). DKA can make it difficult to manage your fluid intake and electrolyte levels which are important to managing sepsis. Sepsis and septic shock are both serious health complications reported in people with the coronavirus.

There is reason to believe that people with type 1 or type 2 diabetes would have different risk levels, more serious complications or be more likely to die as a result of contracting the coronavirus. Factors that are important to consider are coexisting risks including age, other serious chronic conditions and how well-managed your diabetes is.

There is some good news. Diabetics are not more likely than the general population to contract the coronavirus. Leading manufacturers of insulin are also not reporting an impact on their current manufacturing and distribution capabilities for insulin and other diabetes-related supplies at this time.

Make a Plan If You Are Diabetic Before You Get Sick

The American Diabetes Association recommends making a plan before you get sick with the coronavirus. Your plan should include gathering supplies, consulting with your health care team and following the extra precautions listed above.

Your diabetes coronavirus plan should include:

  • Gathering the contact information of your healthcare professionals, pharmacy and insurance company.
  • Creating a list of all your medications, vitamins and supplements with their dosages listed.
  • Stocking up on simple carbs such as soda, Jello-O or popsicles to keep your blood sugar up in case you are too ill to eat.
  • Getting extra refills on your prescriptions and setting up prescription delivery by mail-order if possible. Experts recommend having a 30 to 90 day supply of prescriptions available.
  • Having enough insulin at least for the week ahead. If you are struggling to pay for insulin, the American Diabetes Association has resources to help.
  • Obtaining Glucagon and ketone strips in case of blood pressure lows or highs.
  • Stocking up on cleaning supplies like rubbing alcohol and soap .
  • Asking your doctor when to contact them regarding ketones, changes in food intake and medication adjustments.
  • Asking your doctor when to check for ketones and how often to check your blood sugar.
  • Asking your doctor which medications you should use for colds, viruses, flus and infections.
  • Asking your doctor if you should change medications when sick.

As a Diabetic and/or Senior, What Should I Do to Protect Myself From Coronavirus?

As with any virus, you can take preventative measures to avoid contracting coronavirus, including: 

  • Frequent handwashing with soap and water for at least 20 seconds.
  • Using hand sanitizer with at least 60% alcohol to clean hands if soap and water are not available.
  • If you must be in public, avoid touching high-touch surfaces such as door handles or elevator buttons.
  • If you must touch a high-touch public surface use a tissue or your sleeve as a barrier
  • Avoiding touching eyes, nose, or mouth.
  • Avoiding close contact with infected persons.
  • Clean and disinfect your home regularly, especially frequently touched surfaces such as faucets or light switches.
  • If someone in your household tests positive for the coronavirus, keep everyone at your home.

If you are a diabetic or senior, take extra precautions to avoid contracting the coronavirus, including:

  • Establishing a protected space for you.
  • Having only one family member care for you if you cannot care for yourself.
  • Making sure your caretaker washes their hands thoroughly before they are in direct contact with you.
  • Continuing to monitor your health conditions and keeping appointments with your medical team by telehealth appointments and virtual check-ins whenever possible.
  • Avoiding leaving your home whenever it is not absolutely necessary.
  • Avoiding crowds, especially in poorly ventilated spaces.
  • Avoiding all non-essential travel.

You may be exposed to the virus if you are within six feet of an infected person or through inhaling the respiratory droplets that are produced when an infected person coughs or sneezes. It is possible you can get sick from someone not showing symptoms, but primarily the virus is spread by people displaying symptoms. You may contract the illness through shared surfaces if you touch an orifice of your body such as your eye, nose, or mouth after touching an infected surface.

The CDC does not recommend that people who are well wear face masks. Face masks are recommended for people who show symptoms, healthcare workers and caretakers to help prevent the spread to others.

What Are Symptoms of Coronavirus?

Symptoms of coronavirus may appear 2-14 days after exposure and include: Fever

  • Cough
  • Shortness of breath
  • Breathing difficulties

More severe symptoms may include:

  • Confusion or inability to arouse
  • Bluish lips or face
  • Severe acute respiratory syndrome
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in chest
  • Lower Respiratory tract illness
  • Pneumonia
  • Kidney failure

What Should I Do If I Suspect I Have Contracted Coronavirus?

Due to your elevated risk for serious complications and death as a diabetic and/or senior, it is especially important to seek immediate treatment if you suspect you have contracted the coronavirus. You should also contact your healthcare provider if you may have been exposed to a person with coronavirus or you live in/have traveled to an area with a high concentration of infected people.

If you are diabetic make sure you have the following information available when you call your healthcare professional:

  • Glucose reading
  • Ketone reading
  • Fluid consumption log

There are tests that will help your medical practitioner identify if your symptoms are in fact coronavirus. Once you have been diagnosed, your doctor may suggest:

  • Taking pain and fever medications. If you are diabetic or a senior make sure you know how these interact with your current medications.
  • Drinking plenty of liquids. If you are struggling to keep water down, take small sips every 15 minutes or so throughout the day to avoid dehydration.
  • Staying home to rest, in a protected space if possible.
  • Taking a hot shower to ease sore throat and cough.
  • Using a room humidifier to help with respiratory symptoms.
  • Support for vital organ function in severe cases.

If you are diabetic, be aware that some sensors (Dexcom G5, Medtronic Enlite and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks for accuracy. You may need to check your blood sugar more often throughout the day and night (generally every 2-3 hours).

Your doctor may suggest eating 15 grams of simple and easily digestible carbs if you are diabetic and experiencing low blood-sugar levels below 70mg/dl or your target range. Check for ketones to avoid DKA if you are diabetic and your blood sugar has registered high (BG greater than 240mg/dl) more than 2 times in a row. Immediately contact your doctor if you have medium or large ketones (or if instructed by your doctor, for trace or small ketones).

Ideally, you should proactively consider whether or not your coverage is sufficient should you contract the coronavirus. If you qualify for Medicare, you may want to purchase Medicare supplements to help with out of pocket expenses or Medicare Advantage, which offers added compared with Original Medicare. If you are a diabetic who does not qualify for Medicare, check that your health insurance policy sufficiently covers you for coronavirus related expenses.

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