Fewer health plans waiving cost sharing for COVID treatment
Almost three-quarters (72%) of the nation’s biggest health plans have ceased waiving cost sharing for COVID-19 treatment, while an additional 10% of plans are on track to phase out waivers by the end of October, according to a survey by Peterson-KFF Health System Tracker.
The survey includes both self-funded employers and those buying fully insured coverage.
“Motivated by high profits, ACA medical loss ratio, rebate requirements, public health concerns about managing the pandemic and concern over a federal mandate to cover COVID-19 treatment costs, many insurers offered financial relief to their enrollees amid the coronavirus pandemic, primarily through waived COVID-19 treatment costs and less commonly through premium credits or reductions,” wrote the survey authors.
The authors explained that, earlier in the pandemic, relatively few COVID patients were billed for their hospitalization because of the voluntary waivers extended by private insurers and employers.
“But as vaccines have become widely available to adults in the U.S. and health care utilization has rebounded more generally, health insurers may no longer face political or public relations pressure to continue waiving costs for COVID-19 treatment. As more waivers expire, more people hospitalized for COVID-19—the vast majority of whom are unvaccinated—will likely receive significant medical bills for their treatment.”
According to KFF, 73 out of 102 (the two largest plans in each state plus the District of Columbia) are no longer waiving out-of-pocket costs for COVID treatment. Fifty plans already ended cost-sharing waivers by April 2021, when many states began vaccinating adults.
Of the 29 plans that are still waiving cost sharing for COVID treatment, 10 are scheduled to end in October.
An additional 12 plans said their cost-sharing waivers will end by the end of 2021, two set 2022 as a target date for ending the waivers, and five did not specify an expiration date.
All 102 plans reviewed by KFF had waived cost-sharing for COVID treatment since 2020.
The full survey results are here.