COVID-19 patients to face medical debt burden as insurance plans waive cost sharing


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The average cost of COVID-19 hospitalization is approximately $20,000, with the average out-of-pocket cost of approximately $1,300 per patient

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As a growing number of insurance plans are canceling COVID-19 cost-sharing exemptions amid a surge in vaccinations, more patients will bear the brunt of the medical debt associated with catching the virus.

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Kaiser Family Foundation an estimate That about 72% of the two largest insurers in each state and Washington, D.C., or 102 health plans, are no longer spending out-of-pocket for COVID-19 treatment, while the other 10% of plans will phase out exemptions. the end of October and the other 12% will eliminate the discount by the end of 2021.

Although real-time data on the cost of COVID-19 hospitalization is not publicly available, studies suggest that the average total cost is likely to be around $20,000. One report good The Center for Medicare and Medicaid Service found that Medicare fee-for-service COVID-19 hospitalizations averaged about $24,033, while a Study The average COVID-19 hospitalization cost for Medicare fee-for-service enrollees was $21,752, published by the American College of Physicians.

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KFF estimates that the average out-of-pocket cost for COVID-19 patients averages about $1,300, based on data on the cost of similar care for pneumonia cases. In addition, the nonprofit finds that preventable cost Hospitals treating uninfected COVID-19 patients lost an estimated $5.7 billion between June and August.

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COVID-19 survivor and Las Vegas resident Kenneth Fuchigami told Granthshala Business that his financial troubles began after he caught the virus in December 2020.

Fuchigami said, “My wife had COVID before. I really didn’t believe in the disease.” “So when he had it, I was going to work and one day I wanted to kiss him goodbye. He told me not to do it, but I did it anyway. And the next day, I started having symptoms and I was Like, scared I got it so soon.”

Within a week, his wife’s condition improved, but her condition was deteriorating.

“It got to a point where I felt like I couldn’t breathe. I felt like I was breathing through a straw,” he continued. “Then I told my wife, you know, just take me to the emergency room. When she left me ahead, I felt like I couldn’t even walk and when I got to the emergency room, there’s a huge line. ‘Okay? There’s a lot of people in the waiting room. I think I was so bad they immediately took me in.’

Fuchigami realized that COVID-19 was no joke as he remained in the intensive care unit for almost a month. Nearly a year later, Fuchigami relies on a respirator and supplemental oxygen tank to breathe after severe damage to his lungs and is saddled with thousands of dollars in medical debt, with bills ranging from $25 to as high as $70,000. .

“It’s been ridiculous,” he said. “When I got $70,000, I started getting $1,000 here, $1,000 there, $2,000 here, $800 here. And then the collectors started calling.”

Krutika Amin, Kaiser Family Foundation’s associate director for programs on the ACA, told Granthshala Business that the best course of action for patients suffering from COVID-19 medical debt is to call their hospitals and insurance providers to see if Can they negotiate a cut in the bill?

“Under the CARES Act, Congress provided relief funds and hospitals that are receiving these funds are not allowed to surprise bill patients for anything that their insurance company is not paying and Whatever the hospital is charging when the hospital is out of network,” Amin explained. “So some of those amazing bills can be reduced, but it never hurts to have patients call their hospitals or plans or try to negotiate to lower their costs.”

However, Fuchigami, who lost his insurance coverage after being fired from his job, is no longer eligible for unemployment and cannot afford a payment plan set up by the hospital.

“I asked if there was a payment plan I could set up where I could pay little by little,” he said. “The woman said, ‘Oh yes, we could do that.’ So I said, ‘Okay, what’s the lowest I can pay?’ She goes, ‘You have to pay about $7,000 per month.’”

Fuchigami has since applied for disability and welfare, but says he has received “zero assistance.” He even resorted to rationing his pills after the cost of his medication jumped from $2 and $60 to $500 and $600.

“I’m stuck with all these bills,” he said. “I don’t even try to think about it anymore because it’s just stressing me out.”

Meanwhile, Fuchigami launched a GoFundMe to cover his expenses. The fundraiser has raised nearly $5,000 toward its $6,000 goal.

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