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Americans will most likely pay a lot more for Covid medical care during this new wave of cases – whether it’s a routine coronavirus test or a long hospital stay.
Earlier in the pandemic, most major health insurers voluntarily waived the costs associated with Covid treatment. Patients did not have to pay their normal copayments or deductibles for emergency room visits or hospital stays.
Most of the Covid tests were also free.
The landscape has since changed, as the pandemic continues into its second year. Federal law still requires insurers to cover tests at no cost to the patient when there is a medical reason to seek treatment, such as exposure to illness or the onset of symptoms. But most of the tests sought do not meet the definition of “medical reason” and are instead intended for surveillance.
And insurers now treat Covid more like any other disease, no longer fully covering the costs of care. Some companies, like Delta Air Lines, plan to charge unvaccinated employees higher insurance rates, partly citing high hospital costs for Covid cases.
“Insurers are faced with the question of whether the costs of Covid treatment should fall on everyone, or only on individuals who have chosen not to be vaccinated,” said Cynthia Cox, vice president of the Kaiser Family Foundation which has studied how insurers are. covering Covid treatment.
Federal rules that make coronavirus testing free include exemptions for routine workplace and school testing, which have become more common as students return to class and companies mandate regular testing for them. unvaccinated workers.
Since insurers are not required to cover these regular tests, some patients have already received test bills of up to $ 200 for routine screenings, according to documents patients submitted to a New York Times draft. monitoring costs of Covid testing and treatment. If you have received an invoice, you can submit it here.
Some of the higher bills, however, will likely be for Covid patients who need extensive hospital care now that most insurers no longer fully cover those bills. Seventy-two percent of major health plans no longer make Covid treatment free for patients, a recent study by the Kaiser Family Foundation found.
This includes Florida’s Blue Cross Blue Shield, the largest health plan in a state with one of the nation’s worst epidemics. Florida Blue began requiring patients to pay their normal deductibles and co-payments for Covid treatment on Wednesday. Toni Woods, a spokeswoman, said the plan was now focused on encouraging vaccinations.
“When the Covid-19 pandemic started last year, we put in place several emergency arrangements to temporarily help our members,” she said in a statement. “Medical diagnostic tests for Covid-19 as well as vaccinations continue to be available to members at $ 0 cost sharing.”
Oscar Health, which sells coverage in Florida and 14 other states, also ended free Covid treatment this week. He cited the widespread availability of the vaccine as a main reason.
“We started to forgo cost-sharing of Covid-19 treatment at the height of the pandemic in 2020, when there were few options available for those who fell ill with the virus,” said Jackie Khan , Oscar spokesperson. “We believe the Covid vaccine is our best way to beat this pandemic, and we are committed to covering it and testing at $ 0 for our members. “
The new policies generally apply to all patients, including the vaccinated; people who get sick with a breakthrough infection; and children under 12, who are not yet eligible for the vaccine.
“If you have a small child who gets Covid at school and ends up in the ICU, that family is now going to be stuck with the bill even though that patient hasn’t had the opportunity to get the vaccine,” said Dr. Kao-Ping Chua, a pediatrician at the University of Michigan who studies the costs of Covid care.
An average hospitalization for Covid costs around $ 40,000, researchers have found. A long hospital stay – which requires time in the intensive care unit or an air ambulance transfer – can cost much more. Most insured patients will not pay the full bill; they will meet the share they owe through deductibles and quotas.
Dr Chua and his colleagues published research this summer and concluded that among patients who had to pay for part of their Covid hospitalization, the average costs were $ 3,800.
“There were patients where it was $ 10,000 and others where it was $ 500,” he said. “It gives you a semblance of what things will look like now without the waivers. “
Surprise bills for routine Covid testing could be smaller but more common as schools and workplaces increasingly rely on regular testing to prevent the spread of the coronavirus.
In many workplaces, unvaccinated workers must be monitored at least once a week. Some employers, including the federal government, plan to fully cover the costs of these tests. But others, including some hotels and universities, will require unvaccinated workers to bear some or all of the costs of the tests.
Rebecca Riley recently received a bill for $ 200 from an unknown name lab. When she called to inquire about the fee, she learned it was a fee for a Covid test. Her son, a high school student, is tested regularly at his Los Angeles-area high school.
“I didn’t expect to receive invoices,” she said. “I feel stupid, but I had heard that the tests were free.”
Ms. Riley contacted her insurer about the charges, and the insurer agreed to pay the full amount. But she is now worried about future bills for surprise testing. “I really feel sorry for the families who will not be able to pay,” she said.
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