Over the first year of the pandemic most health insurance companies voluntarily waived the cost of co-pay and deductible payments for COVID patients, largely because they expected the Federal Government to eventually require them to do so.
However, that never actually happened, and so, now that vaccines have been available for more than six months, most companies have ended the COVID payment waivers effective September 1, 2021. The justification is that over 90% of the current cases are now among the unvaccinated and could thus have been prevented.
That insurance company decision means that now, for at least 72% of America’s individual health policy holders, continuing to choose to not be vaccinated could also be a financial decision that ends up costing them their house.
Estimates of the cost of a COVID hospital stay vary, but average being in the $20,000 to $80,000 price range, with ICU cases easily topping out at $100,000+.
Again, if you have been vaccinated, or have a strong medical reason to not be, this should not apply to you, but if you have chosen to remain unvaccinated, today is a good day to check your own policy to see what your choice might mean for you.
$2.4B: THE OVERALL FINANCIAL BURDEN OF COVID SO FAR
The Peterson Center on Healthcare and the Kaiser Family Foundation are partnering to monitor how well the US healthcare system is performing so far in terms of quality and cost when it comes to dealing with the pandemic.
Their Peterson-KFF Health System Tracker provides clear, up-to-date information on trends, drivers and issues that impact the performance of the system. It also illustrates how the US is performing relative to other countries, and how different parts of the nation’s system are performing relative to one another.
According to their study on COVID-19 posted on August 20, 2021:
“Our analysis of CDC data indicates there were 37,000 preventable COVID-19 hospitalizations in June [2021] and another 76,000 preventable COVID-19 hospitalizations in July [2021], among unvaccinated adults in the US…
If each of these preventable hospitalizations cost roughly $20,000, on average, that would mean these largely avoidable hospitalizations have already cost the U.S. health system… over $2 Billion.”
More precisely, the total $2,380,000,000 according to their calculations, and it’s based on the lowball estimate of the cost of each treatment.
WHAT ABOUT MEDICARE?
Medicare beneficiaries without a Medicare Advantage plan (the supplemental or “gap” policy that covers some costs that Medicare doesn’t pay) for hospital inpatient services currently pay a deductible of $1,408 and no co-insurance payments for days 1- 60 of each benefit period. After those initial 60 days, beneficiaries pay a co-insurance payment of $352 per day for days 61- 90 of each benefit period.
If you have a Medicare Advantage plan, your cost-sharing amount will depend on your plan, and again, though many of these insurers have waived COVID-related co-payments up to now, they are under no obligation to continue to do so. It is widely expected that the providers of Medicare Advantage plans will soon follow the standard now set for those below retirement age.
In Summary
By adding a new strong financial incentive to vaccination, the medical health insurance industry has made a personal choice to stay unvaccinated more challenging for those still on the fence. It has also made clear the real costs of those who continue to do so. The action not to vaccinate is not made in a vacuum – it is an action (or inaction) with consequences that affect all of us.
If this still applies to you, and you are still unpersuaded that you need to be vaccinated for medical reasons, perhaps you should now ask yourself a new question: Do you believe that your finances can withstand the substantial hit of $20,000 to $80,000?
For more updates from the Peterson-KFF Health System Tracker, go to: healthsystemtracker.org/