With highly effective coronavirus vaccines available and hospital admissions soaring, many Covid-19 patients are facing bigger bills as most insurance companies have ended waivers on out-of-pocket costs that they introduced earlier in the pandemic, according to the Kaiser Family Foundation, a cost that will be primarily borne by the unvaccinated people more likely to require hospital treatment.
Earlier in the pandemic, the vast majority of private health insurers voluntarily waived out-of-pocket costs for Covid-19 treatment, meaning some 88% of people with insurance coverage would have paid nothing if hospitalized.
With no federal mandate requiring insurers to waive these costs, few regulations requiring them to do so at the state level and the wide availability of effective vaccines, the majority have now passed these costs back to patients, according to research by the Kaiser Family Foundation.
Of the two largest health plans in each state and Washington, D.C., nearly three-quarters (72%) are now passing out-of-pocket costs—including copays and payments towards deductibles—for Covid-19 treatment back to patients, KFF found.
The 102 providers studied represent 62% of enrollment across fully insured individual and group markets, KFF said.
Almost half of the insurers studied had terminated waivers by April, roughly the time all adults in the country became eligible for a vaccine, and the majority of those still eating the costs—nearly a quarter of the the insurers studied—intend to stop by the end of the year.
Of the remainder, two plans (around 2% of the total) have waivers set to expire by March 2022 and just five (around 5%) do not specify when waivers will expire.
While Covid-19 vaccines and most coronavirus tests are supposed to be free, Americans hospitalized with coronavirus can still be billed for care. Even with comprehensive coverage, the usual suite of deductibles, copayments and coinsurance apply, and many of those admitted to a hospital have received surprise bills of astronomical sizes upon leaving. With Covid-19 cases and hospital admissions surging—primarily among unvaccinated people across the country—and waivers coming to an end, it is likely that many people will be receiving bills for treatment. New waivers are possible—some due to expire in October are pegged to the ending of the federal Public Health Emergency—though perhaps unlikely given the availability of free vaccines that are highly effective at preventing serious illness and hospitalization. Many believe vaccine holdouts should have to pay more for their health insurance and employers are reportedly considering raising premiums to try and employees to get the shot. Polling suggests Americans are neatly divided on the issue, with around half (49%) in favor of employers charging unvaccinated people more for insurance. Of those opposing, 73% were not vaccinated.
Just over half of the U.S. population is fully vaccinated against Covid-19. The vast majority of those hospitalized with the infection have not received it. Almost all of those dying from Covid-19 have not. Not all are eligible for vaccination, however, and hospitals are filling up with record numbers of children suffering from the disease and younger people who may not have been eligible for the shot for very long.
$1,644. That’s how much the typical deductible in an employer health plan is, according to KFF. The cost was generally larger for workers at small firms (less than 200 workers)—an average of $2,295.
How The Pandemic Now Ends (The Atlantic)