ANN ARBOR, Mich. — Up until now, most Americans have had their hospital bills related to severe COVID-19 symptoms covered by a combination of insurance companies and government relief plans. Of course, you didn’t need a crystal ball to know that wouldn’t last forever. Now, as insurance companies begin wrapping up their “pandemic grace periods,” researchers from the University of Michigan predict many older Americans will end up owing thousands of dollars in COVID hospital costs.
Each individual case is different, but the study finds after accounting for co-pays, deductibles, and co-insurance, the average COVID-19 patient over 65 years-old will owe around $1,000 after leaving the hospital. Many others will likely owe far more.
Researchers based these estimates on an analysis of out-of-pocket costs incurred and paid for by hospitalized influenza patients with Medicare Advantage plans in 2018. For reference, a “Medicare Advantage plan” is a Medicare plan run by a private insurance company. That last point is important because close to 40 percent of older Americans have this kind of health insurance. Moreover, studies continue to find older individuals are at an elevated risk of experiencing severe COVID-19 symptoms and requiring hospitalization.
Costs slowly shifting to COVID patients for treatment
Currently, most insurers continue to cover all COVID-19 hospital fees for their Medicare Advantage enrollees. However, one insurer began allowing cost-sharing for its non-Medicare Advantage enrollees in early February 2021. Study authors say this is a clear sign that cost-sharing waivers for COVID costs are not here to stay.
“Insurers may choose to extend their waivers for enrollees with Medicare Advantage and private insurance coverage,” says Kao-Ping Chua, M.D., Ph.D., the study’s first author and an assistant professor at the U-M Medical School, in a university release. “But if they don’t, patients will be faced not only with the physical and emotional toll of COVID-19 hospitalizations, but also the financial toll.”
Along with colleagues from Boston University, the Michigan team analyzed data on 14,278 people hospitalized with the flu in 2018. On average, those patients spent six days in the hospital and one-third needed intensive care. That’s roughly the same amount of time that most older COVID-19 patients spend hospitalized.
While the average cost of this care came in around $1,000, three percent of flu patients needing intensive care received bills in excess of $2,500 at the end of their hospital stay.
Researchers admit that there is no one-for-one comparison when it comes to COVID-19. Despite some differences however, respiratory infection hospitalizations are still fairly similar when it comes to the care patients receive.
Study authors worry that many Americans will avoid getting the coronavirus treatments they need over monetary concerns. They recommend federal legislation mandating that insurers fully cover COVID-19 medical bills throughout the entire pandemic.
The study is published in the American Journal of Preventive Medicine.