Why are insurers charging again?

doctor holding syringe and using cotton before make injection to patient in a medical mask. Covid-19 or coronavirus vaccine
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To help stop the spread, the U.S. government ensures COVID-19 vaccines are completely free of charge. The same goes for COVID-19 testing.

This, however, is not true for treatment. While a handful of states demanded insurers waive cost sharing for patients, most of the companies that did so nationwide acted voluntarily.

Insurers may have feared heavy-handed government intervention if they didn’t act first by volunteering, the Kaiser Family Foundation suggests.

Now, with vaccines widely available, insurers may no longer feel as much pressure to pay for illnesses that could have been avoided or reduced in severity by getting jabbed.

Several insurers, like Independence Blue Cross and Medica, are still waiving costs for some plans but will stop by Oct. 31.

How much does COVID-19 care cost?

Infected patient in quarantine lying in bed in hospital, coronavirus concept.
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With waivers quickly coming to an end, patients will need to pay any fees associated with their standard health insurance policy. That means your deductible, coinsurance and copayments plus the cost of any services that aren't covered.

How much can that be? It depends on how severe your illness is.

A woman named Janet Mendez told The New York Times that she spent 19 nights in hospital and needed to use a ventilator. Her medical bills totaled over $400,000, but with insurance she expects to pay under $10,000.

Meanwhile, Casey Gray told CNN that he was hospitalized for 75 days, racking up a whopping $3,400,000 bill. He too ended up paying about $10,000, due to his insurance.

A recent study found those without cost-sharing waivers paid an average of $3,800 out of pocket if they had private insurance and an average of $1,500 if they had a Medicare Advantage plan.

For those with a Marketplace plan, the maximum you can be asked to pay this year is $8,550 for an individual and $17,100 for a family. Some plans have even lower limits.

How to protect yourself

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While most out-of-pocket waivers are long gone, there’s plenty you can do to ensure you won’t suffer a mammoth bill on top of getting sick.

If you don’t have insurance, get it

Out-of-pocket costs can be painful, but the damage will be much, much worse if you don’t have coverage at all.

For a patient without insurance, the average cost of a COVID-19 hospital stay is about $73,300, a FairHealth study found.

Some states like California, New Jersey and New York have extended open enrollment until the end of the year, meaning you still have time to browse your options on the Marketplace or sign up at work.

If you absolutely can’t secure insurance at the moment, you can try asking your medical provider to bill the government’s HRSA COVID-19 Uninsured Program.

However, only certain providers are participating, not all of your medical costs may be covered, and it won't protect you from other illnesses and injuries.

If you do have insurance, rethink your coverage

Now that insurers aren’t waiving out-of-pocket costs, you’ll likely need to cover a few thousand dollars in deductibles, copays and coinsurance.

If you have a high-deductible plan, consider upgrading to get a lower deductible. Or you may want to consider switching to a plan without a copay.

These choices do come with a higher premium — but thanks to government relief efforts, Marketplace plans are even more affordable than usual.

Premiums are currently limited to no more than 8.5% of your income, and millions more people can take advantage of generous subsidies.

It’s worth a few minutes to compare plans and providers to see how much further your money can go — a strategy that could also save you as much as $1,000 a year on your car insurance and home insurance.

About the Author

Chris Murray

Chris Murray

Freelance Contributor

Chris Murray is a freelance contributor with Moneywise.com

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