Medicare plan COVID-19 FAQs

Get answers to common questions about Medicare and COVID-19. Find out about prevention, testing, treatment, vaccinations, coverage, and more. 

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Get personalized plan details

We're here to make sure you're in the know when it comes to COVID-19.

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Sign in to your member account

Find out exactly what your plan has to offer.

When you sign into your account, you’ll find detailed information about your:
  • Benefits and coverage
  • Prescription medications
  • Claim history
  • Network providers
  • And more
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Testing

Medica Prime Solution (COST), Medica Advantage Solution (HMO, HMO-POS, PPO), including Medica Advantage Solution PartnerCare (HMO I-SNP)


The following testing coverage is effective from Feb. 4, 2020 to October 31, 2021:

Medica Prime Solution and Advantage Solution will cover the cost of medically necessary COVID-19 diagnostic testing. Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets Centers for Disease Control (CDC) and the Food and Drug Administration (FDA) guidelines, and is ordered by an appropriate medical professional.*

Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. That means the member's share of the cost will be waived for COVID-19 testing in office visits, urgent care, walk-in retail health clinics, emergency room, and outpatient facilities if the member is being tested for COVID-19.

Medica Medicare Supplement (Medigap)


The following testing coverage is effective from Feb. 4, 2020 to October 31, 2021:

Medica Medicare Supplement (Signature Solution) will cover the cost of medically necessary COVID-19 diagnostic testing (COVID-19 infection). Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets Centers for Disease Control and the Food and Drug Administration (FDA) guidelines, and is ordered by an appropriate medical professional. Tests done as part of a return-to-work requirement, public surveillance program, or travel requirement aren't covered.

Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. That means the member's share of the cost will be waived for office visits, urgent care, walk-in retail health clinics, emergency room, and outpatient facilities when the member is being tested for COVID-19.

Medica Medicare Supplement (Select Solution) will cover the cost of medically necessary COVID-19 diagnostic testing. We cover rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets Centers for Disease Control and the Food and Drug Administration (FDA) guidelines, and is ordered by an appropriate medical professional. Tests done as part of a return-to-work requirement, public surveillance program, or travel requirement aren't covered.

Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. That means the member's share of the cost will be waived for COVID-19 testing in office visits, urgent care, walk-in retail health clinics, emergency room, and outpatient facilities if member is being tested for COVID-19.
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Treatment

Is treatment for COVID-19 covered?

Medica Prime Solution (COST), Medica Advantage Solution (HMO, HMO-POS, PPO), including Medica Advantage Solution PartnerCare (HMO I-SNP)


Treatment Coverage (effective February 4, 2020 to October 31,2021)

Medica Prime Solution and Advantage Solution individual plans will cover the cost of COVID-19 treatment at no cost to members in these situations:

  • In a hospital participating with their Medica network
  • When accessing extended absence and travel benefits, or in an emergency (i.e. admission through an emergency room)
  • If the provider/hospital is Medicare eligible
    Medica Advantage Solution group retiree plans will cover the cost of COVID-19 treatment if the provider/hospital is Medicare eligible, at no cost to members.

    Medica Medicare Supplement (Medigap)


    Treatment Coverage (effective February 4, 2020 to October 31,2021)

    Medica Medicare Supplement (Signature Solution) will cover the cost of COVID-19 treatment at no cost to members in a hospital setting, as long as the provider/hospital is Medicare eligible.

    Medica Medicare Supplement (Select Solution) will cover the cost of COVID-19 treatment at no cost to members in a hospital that participates with their Medica-contracted network.

Will prior authorization requirements for care requests be waived?

Yes. Prior authorization isn’t required for admissions to long-term care facilities, acute inpatient rehabilitation, and skilled nursing and home health care facilities. This change is in effect through October 31, 2021.

Will early refills for prescriptions be authorized? 

Maybe. If you have prescription benefits with us, and your medication needs to be filled early, submit your refill request to your pharmacy. They will determine if your prescription can be filled early.

Can I get a 90-day supply of my prescription medication(s)?

Maybe. Members can request a 90-day supply of some long-term medications used to treat chronic conditions. At this time, we will not authorize requests to fill medications that are not eligible for 90-day refills.

90-day Prescription Services

To reduce your trips to the pharmacy, you can get up to a 90-day supply at one time from a participating retail pharmacy location.

Applies to:

  • Medica Prime Solution Plan members (COST)
  • Medica Advantage Solution (HMO, HMO-POS, and PPO)

Learn more about 90-day refill options.

How can I get prescriptions without leaving home?

Your options include:

1. Home delivery (mail-order) prescription services

Mail order home delivery of your prescriptions is available with most Medica plans. This convenient service also can save you money.

Learn more and request mail order delivery.

2. Retail pharmacy home delivery

Many retail pharmacies will mail your prescription to your home, free of charge. Some home delivery requests may require an in-person office visit and a new prescription from a prescriber. Check with your pharmacy for details.

Applies to:

  • Most Medica Prime Solution Plan members (COST)
  • Medica Advantage Solution (HMO, HMO-POS, and PPO)

Are virtual care services available?

Yes. Virtual or telehealth visits are covered as part of your plan. Those may be through Virtuwell or with another network provider. Virtuwell is an online clinic staffed by nurse practitioners who help treat common non-emergencies like pink eye, common colds, earaches, and more.

We've expanded the availability of telehealth visits to include visits that:

  • Are from your home
  • Use technologies such as FaceTime or Skype
  • Use audio only when video is not available

Virtual staff also offer a free test to help you determine if your symptoms resemble COVID symptoms. Your visit starts with a quick online interview before a nurse practitioner reviews your case. The service costs $0 and often takes less than 30 minutes.

Keep in mind:

  • Virtual visits aren't for emergencies
  • Most providers are available 24 hours a day, 7 days a week
  • You don't need an appointment

Applies to:

  • Medica Prime Solution Plan members (COST) (except Thrift, Core in NE, Premier in NE, and Group retiree plans)
  • Medica Advantage Solution (HMO-POS and PPO) (except Group retiree plans)
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Vaccination

What can you tell me about the vaccine for COVID-19?

Get answers to frequently asked questions about COVID-19 vaccine coverage and availability in this PDF.

*Not covered as part of a return to work requirement, public surveillance program or travel requirement. 


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Last Updated: July 2021


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