COVID-related hospital bills on the rise as insurance policies change during pandemic

Widespread vaccine availability has changed the math, a Kaiser Family Foundation analysis found.
Published: Nov. 1, 2021 at 2:23 PM EDT
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LEXINGTON, Ky. (WKYT) - With vaccines now widely available, many insurance companies are changing or have changed their policies, leading to higher out-of-pocket costs for hospitalized COVID-19 patients now compared to earlier in the pandemic.

“This is potentially going to cause some financial ruin for a lot of people, too,” said Cynthia Cox, vice president of the Kaiser Family Foundation.

A Peterson-Kaiser Family Foundation Health System Tracker analysis found that fewer health insurance companies are still waiving costs of COVID treatment. That means bigger bills could be coming, if they have not already.

When the pandemic first began, Congress acted to make some COVID testing and all COVID vaccination free for patients. They did not require insurers to cover COVID treatments, but many voluntarily did: KFF analysts found that 88 percent of people enrolled in fully-insured private health plans had out-of-pocket costs waived if they ended up in the hospital with COVID-19.

Now, with the vaccine widely available, those waivers have been phasing out.

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“I would say by the end of the year it’s going to be rare that someone can get COVID and not get a bill at the other end if they have private coverage,” Cox said.

The KFF found that 72 percent of the two largest health plans in each state stopped waiving cost-sharing by August. Another six percent expired in September. Another 16 percent will have expired by the end of the year.

Doctors and health experts say the vaccine is highly effective at preventing serious illness, hospitalization and death.

Another KFF analysis found that largely preventable COVID hospitalizations of unvaccinated people have cost close to $6 billion just since June, putting strain on their health, the healthcare system and patients’ own wallets.

“It’s not just devastating for your health, it’s also devastating for your finances,” Cox said, “because a lot of people don’t have a few thousand dollars in the bank that they can just drop on an unexpected hospitalization.”

Experts say most testing costs are still covered when there is a medical reason, like symptoms or exposure, but tests for monitoring purposes do not have to be fully covered.

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