Revenue Cycle
and Billing

When the COVID pandemic first hit the US, most health plans gave their enrollees who got the virus a break. They waived deductibles, coinsurance, and copayments for the treatment of the disease. But many of these waivers have already expired or will expire by the end of the year. 

That means if you get COVID-19, your health might not be the only thing that suffers. Your wallet might too.

Private Insurance

A Peterson-KFF Health System Tracker brief looked at COVID treatment waivers of the 2 largest private health plans in each state and the District of Columbia (see figure below). These plans cover 62% of enrollees across the fully insured individual and group markets across the US. According to the brief:

  • 72% of the plans no longer waive cost-sharing for COVID-19 treatment: 
    • Many of the waivers expired by April 2021. 
  • 24 plans will end cost-sharing waivers soon:
    • 10 plans will end the waivers by October 31.   
    • 12 plans have waivers that expire December 31, 2021.

Cost-sharing Waiver Expiration Dates of the 2 Biggest Plans in Each State and Washington, DC.

Source: KFF Analysis of Insurer Websites and AHIP

What COVID Treatment Could Cost You

The brief also looked at the average costs of treating pneumonia among employer health plans, which is similar to COVID-19 care. The average out-of-pocket cost for a patient was $1,300. 

The amount will vary based on your deductibles, coinsurance, and copayments, as well as by the type and length of care you need. Check with your health plan to see you will have to pay your share of costs if you get the virus, and how much you could have to pay.

Vaccines and Testing Are Still Free

All COVID-19 vaccines are free for everyone, even if you don’t have insurance. You don’t have to pay anything for the vaccine. If you have a medical reason to get a COVID test, it is also free. 

The amount you could have to pay out-of-pocket to treat the virus could be the incentive you need to get the COVID-19 vaccine. Take care of your health and your wallet and get the jab.

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