What the End of COVID-19 Emergencies Means for Older Adults

At-home COVID tests cost around $10 each, or about $20 for a pack of two. People who can’t afford to buy over-the-counter tests may be able to find free tests at community health centers. 

A few exceptions: For people with Medicaid, coverage for at-home tests will continue through the end of September 2024. And the federal government has announced that Americans can still order four free at-home COVID tests per household on its website through the end of May. A recent report from the Centers for Disease Control and Prevention found that 1 in 3 U.S. households used these government-supplied kits. 

A bit of advice from Anna D. Sinaiko, assistant professor of health economics and policy at the Harvard T.H. Chan School of Public Health: Get some to keep on hand while you still can.

COVID-19 vaccines will remain free for now  

Even when the federal supply of vaccines is depleted, most people will be able to get them for free. Medicare and Medicaid will continue to fully cover the COVID-19 vaccines for their beneficiaries, and the majority of people with private insurance will also be covered without copay. 

For the millions of Americans without health insurance, the U.S. Department of Health and Human Services (HHS) announced a program to cover the costs of vaccines through 2024. 

Treatments could eventually come with costs

Oral antiviral treatments like Paxlovid and a similar drug called Lagevrio have helped keep many adults with COVID-19 out of the hospital. And ever since they became available, in late 2021, they’ve been free for Americans.

These oral antivirals will remain free while government supplies last, but after that, out-of-pocket expenses for certain treatments, such as Paxlovid and Lagevrio, may kick in, depending on your health care coverage. HHS says these expenses “will be similar to costs one may incur for other drugs and treatments through traditional coverage.” 

Medicaid programs will continue to cover COVID-19 treatments without cost sharing through September 2024, HHS says. After that, coverage and cost sharing may vary by state. And the same program set up to make vaccines free through 2024 for uninsured Americans will cover treatments during this time as well. 

Changes in other flexibilities

Beyond vaccines, tests and treatments, the emergency declarations have granted a range of flexibilities within the health care system that will end. For example: The three-day hospitalization requirement that Medicare patients had to meet before continued care at a skilled nursing facility would be covered was waived during the pandemic. That rule goes back into effect. 

Also, throughout the pandemic, Medicare Advantage plans have been required to charge in-network prices for care provided at out-of-network facilities. This flexibility was part of the national emergency that ended April 10.

A bigger change has to do with Medicaid coverage. People who have been on Medicaid these last few years could soon be without it due to a continuous enrollment provision that ended on March 31. (This benefit, which barred states from removing people from Medicaid during the pandemic, was previously tied to the public health emergency but ended earlier.) In fact, KFF estimates that between 5 million and 14 million people could lose their Medicaid insurance.

It’s important for people with Medicaid to pay attention to their plan in the coming months, said Salama Freed, an assistant professor in the Department of Health Policy and Management at George Washington University’s Milken Institute School of Public Health. And if they get disenrolled, they’ll need to have another option and prepare for any extra costs.  

“I don’t want anyone to be caught off guard losing their insurance coverage and have to scramble and find something else,” Freed said. “I just want people to have their ducks in a row, so that they’re not caught flat-footed.”

Some people who get disenrolled from Medicaid may be eligible for Medicare. Sharfstein said it’s going to be important for states to identify these people and to help them enroll in new coverage plans. For people not yet eligible for Medicare, there will be a temporary special enrollment period for plans on HealthCare.gov.

One change brought on by the pandemic that’s sticking around, at least for now, is expanded telehealth. More than 28 million Medicare beneficiaries dialed into doctors’ appointments during the first year of the pandemic, a report from HHS shows. New legislation extends telehealth benefits for Medicare beneficiaries through 2024. 

States already have “significant flexibility with respect to covering and paying for Medicaid services delivered via telehealth,” HHS says. These flexibilities will remain in place. 

End of emergencies doesn’t mean end of COVID-19

One thing that doesn’t end when the declarations do is COVID-19, Sharfstein points out. Cases, deaths and hospitalizations have plummeted since the peak of the omicron surge last winter. Still, more than 1,100 Americans are dying each week from COVID-19, federal data shows. 

People should “continue paying attention to the virus,” Sharfstein said. Stay up to date on your vaccines, he advises, watch out for symptoms, and test yourself if you’re going to be around vulnerable people. “The virus doesn’t care whether there’s a public health emergency declaration or not,” Sharfstein said.​