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Covid Medical Payments Are About to Get Larger

Americans will most likely pay significantly more for Covid medical care during this new wave of cases – be it a routine coronavirus test or an extended hospital stay.

At the beginning of the pandemic, most of the major health insurers voluntarily waived the costs associated with Covid treatment. Patients did not have to pay their normal co-payments or deductibles for emergency admissions or hospital stays.

Most of the Covid tests were also free.

The landscape has changed since then as the pandemic continues into its second year. Federal law still requires insurers to take tests at no cost to the patient if there is a medical reason to seek treatment, such as: B. exposure to the disease or the appearance of symptoms. But more of the tests sought do not meet the definition of “medical reason” and are instead used for monitoring.

And insurers are now treating Covid like any other disease and no longer fully covering care costs. Some companies, like Delta Air Lines, are planning to charge unvaccinated employees higher insurance rates, due in part to the high hospital costs for Covid cases.

“Insurers are faced with the question of whether the cost of Covid treatment should go to everyone or just to the people who have chosen not to have a vaccine,” said Cynthia Cox, vice president of the Kaiser Family Foundation, which has studied how insurers are Covering Covid Treatment.

The federal rules that make coronavirus testing free include exemptions for routine workplace and school tests, which have become more common as students return to the classroom and companies mandate regular testing for unvaccinated workers.

Because insurers don’t have to do these regular tests, some patients have already received test bills of up to $ 200 for routine checkups, according to documents given to a New York Times project to track the cost of Covid testing and patients -Treatment submitted. If you have received an invoice, you can submit it here.

However, some of the highest bills are likely to affect Covid patients who need extensive hospital care as most insurers no longer cover these bills in full. 72 percent of the major health insurers no longer make Covid treatment free of charge for patients, according to a recent study by the Kaiser Family Foundation.

That includes Blue Cross Blue Shield of Florida, the largest health plan in a state that is experiencing one of the worst outbreaks in the country. On Wednesday, Florida Blue began obliging patients to pay their normal deductibles and co-payments for Covid treatment. Toni Woods, a spokeswoman, said the plan now focuses on promoting vaccinations.

“When the Covid-19 pandemic started last year, we put several emergency arrangements in place to temporarily help our members,” she said in a statement. “Medical diagnostic tests for Covid-19 and vaccinations are still available to members at a cost of US $ 0.”

Oscar Health, who sells coverage in Florida and 14 other states, also ended free Covid treatment this week. The main reason she cited was the widespread availability of the vaccine.

“We started to forego co-payment for Covid-19 treatment at the height of the pandemic in 2020 when there were few options for those who contracted the virus,” said Jackie Khan, an Oscar Spokeswoman. “We believe the Covid vaccine is our best way to beat this pandemic and we are determined to cover it and test it for our members at $ 0.”

The new guidelines generally apply to all patients, including those who have been vaccinated; People who develop a breakthrough infection; and children under 12 who are not yet eligible for the vaccine.

“If you have a young child who gets Covid in school and ends up in intensive care, this family is now billed with the bill even though that patient did not have the opportunity to get vaccinated,” said Dr. Kao-Ping Chua, a University of Michigan pediatrician studying care costs for Covid.

The average hospital stay with Covid costs around $ 40,000, researchers have found. An extended hospital stay – one that requires ICU time or being moved by ambulance – can cost many times more. Most policyholders don’t pay the entire bill; they will pay the portion they owe through deductibles and co-payments.

Dr. Chua and his colleagues published a study this summer that found that for patients who had to pay for part of their Covid hospital stay, the average cost was $ 3,800.

“There were some patients that cost $ 10,000 and others that cost $ 500,” he said. “It gives you a glimpse of what things will be like now without the waivers.”

Surprise bills for routine Covid tests could be smaller but more frequent as schools and workplaces increasingly rely on regular screenings to prevent the spread of the coronavirus.

In many workplaces, unvaccinated workers are required to undergo surveillance at least once a week. Some employers, including the federal government, plan to cover the cost of these tests in full. But others, including some hotels and universities, will require unvaccinated workers to pay part or all of the testing cost.

Rebecca Riley recently received a $ 200 bill from a lab with an unknown name. 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 regularly tested at his high school in Los Angeles.

“I didn’t expect to get any bills,” she said. “I feel stupid, but I heard the tests were free.”

Ms. Riley contacted her insurer about the fee and they agreed to pay the full amount. But she’s now worried about future surprise test calculations. “I really feel for the families who can’t pay,” she said.

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