COVID-19 patients will face medical debt burden as insurance plans move away from cost sharing

As a growing number of insurance plans roll back COVID-19 cost-sharing exemptions amid increased immunizations, more patients will have to bear the brunt of the medical debt associated with catching the virus.


The Kaiser Family Foundation estimates that about 72% of the two largest insurers in each state and Washington, DC, or 102 health plans, no longer waive out-of-pocket costs for COVID-19 treatment, while an additional 10% of the plans will. phase out the waivers by the end of October and a further 12% will phase out the waivers by the end of 2021.

Although real-time data on the cost of COVID-19-related hospitalizations is not publicly available, studies suggest the average total cost is likely around $ 20,000. A report from the Centers for Medicare and Medicaid Service found that Medicare fee-for-service COVID-19 hospitalizations averaged around $ 24,033, while a study released by the American College of Physicians found that the average COVID-19 hospital cost for Medicare-enrolled in-service hospital costs was $ 21,752.

KFF estimates that the average cost of COVID-19 patients is about $ 1,300 on average, based on data relating to the cost of similar care for pneumonia cases. In addition, the non-profit organization finds that the preventable costs of treating unvaccinated COVID-19 patients in hospitals between June and August reached around $ 5.7 billion.


COVID-19 survivor and Las Vegas resident Kenneth Fuchigami told FOX Business his financial troubles began after catching the virus in December 2020.

“It was my wife who got COVID first. I didn’t really believe in the disease,” Fuchigami said. “So when she got it, I was going to work and one day I wanted to kiss her goodbye. She told me not to do it, but I did it anyway. And the next day, I started having symptoms and I was, like, panicked that I got it so quickly. ”

Within a week, his wife’s condition improved, but his was getting worse.

“It got to a point where I felt like I couldn’t breathe. I felt like I was breathing through a straw,” he continued. “So I said to my wife, you know just take me to the ER. When she dropped me off in front I felt like I couldn’t even walk and when I got to the ER he There’s a big queue, isn’t there? There are a lot of people in the waiting room. Guess I was so bad they greeted me right away. “

Fuchigami realized that COVID-19 was no joke because he was in the intensive care unit for about a month. Almost a year later, Fuchigami is dependent on a respirator and an extra oxygen tank to breathe after severe lung damage and has been saddled with thousands of dollars in medical debt, with bills ranging from $ 25 to $ 70,000.

“It was ridiculous,” he said. “After I got $ 70,000, I started being billed $ 1,000 here, $ 1,000 there, $ 2,000 here, $ 800 here. And then the collectors started calling.”


Krutika Amin, Kaiser Family Foundation associate director for the ACA program, told FOX Business the best course of action for patients with COVID-19 medical debt is to call their hospitals and their insurers to see if they can negotiate bill reductions.

“Under the CARES Act, Congress provided relief funds and hospitals that receive those funds are not allowed to surprise patients for anything their insurance company might not pay and anything the hospital bills if the hospital is off-grid, ”Amine explained. “So some of those surprise bills could be alleviated, but it never hurts patients to try to call their hospitals or their plans or try to negotiate their costs down.”

However, Fuchigami, who lost his insurance coverage after being made redundant, is no longer eligible for unemployment and cannot afford the payment plan established by the hospital.

“I asked if there is a payment plan that I can put in place to pay off bit by bit,” he said. “The lady said, ‘Oh yeah, we could do that.’ So I said, “Well, what’s the lowest price I can pay?” She said, ‘You’re going to have to pay around $ 7,000 a month.’ “

Fuchigami has since filed for disability and welfare, but says he has received “no help”. He also resorted to rationing his pills after his drug costs dropped 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 just stresses me out.”

In the meantime, Fuchigami has started a GoFundMe to cover his expenses. The fundraiser raised nearly $ 5,000 to reach its goal of $ 6,000.

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