Most folks who became gravely ill with COVID last year didn’t face crushing medical bills because nearly all insurance companies agreed to waive cost-sharing for coronavirus care during the height of the pandemic, explained Dr. Kao-Ping Chua, a health policy researcher and pediatrician at the University of Michigan.
But some people did get a big bill because their insurer refused to waive cost-sharing, and their debts provide a good idea of what many hospitalized COVID patients will have to pay this year, Chua said.
“We’ve had some really big insurers abandon their cost-sharing waivers this year,” Chua said. “Insurers seem to be acting like the pandemic is over, and we feel that it’s premature for them to be acting in that manner.”
Chua noted that as of last week, some 20,000 Americans were hospitalized for COVID even though there’s been a continuing decline in cases.
For this study, Chua and his colleagues reviewed claims data for multiple insurers across the United States, looking specifically for people who got a full bill for their COVID hospitalization.
They identified more than 4,000 hospitalizations between March and September 2020 where it didn’t appear the insurer waived cost-sharing. These patients had to pay a share of all their care, from hospital room and board down to the doctors who saw them and the medications they received.
Folks who didn’t benefit from cost-sharing waivers wound up paying about $3,800, on average, out of pocket if they had private insurance and an average of $1,500 if they were covered by a Medicare Advantage plan, the data showed.
“Now that insurers are abandoning their cost-sharing waivers, that’s approximately what the bills might be for patients covered by plans that have chosen to do that,” Chua said.
By comparison, respiratory infections in the pre-COVID period from 2016 to 2019 resulted in average out-of-pocket spending for privately insured folks of $1,600 to $2,000, researchers said in background notes.