Many major insurers no longer waiving out of pocket costs for COVID-19 care

As highly effective coronavirus vaccines are available and hospitalizations continue to surge largely among the unvaccinated, nearly three-quarters of health care plans are no longer waiving out-of-pocket costs, according to a briefing by the Kaiser Family Foundation. 

Earlier in the pandemic, the majority of private health insurers voluntarily waived out-of-pocket costs associated with COVID-19 treatment, suggesting about 88% of people with insurance would have paid nothing if hospitalized.

But, with no federal mandate requiring insurers to waive these costs, the majority have instead pushed the costs back on the patient, according to research by the foundation.

"We find that 72% of the two largest insurers in each state and DC (102 health plans) are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October," the company wrote. "Almost half these plans (50 plans) ended cost-sharing waivers by April 2021, which is around the time most states were opening vaccinations to all adults." 

Of the 29 plans still waiving cost-sharing for COVID-19 treatment, the foundation said 10 waivers are set to expire by the end of October and another 12 plans state will expire by the end of 2021.

"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," Kaiser continued. 

This news comes as the FDA recently gave full approval of the Pfizer vaccine earlier this week. While COVID-19 vaccines and most coronavirus tests continue to be free, those who are hospitalized with the infection can still be left with substantial bills. 

Though new waivers are possible, it’s less likely that insurers will do this considering the vaccines’ high levels of efficacy toward preventing severe illness.

Insurer Blue Cross Blue Shield responded to FOX's request for comment. 

"Every BCBS company makes its own COVID-19 benefit and coverage decisions. Companies have been revisiting patient payment waivers on COVID-19-related treatments throughout the pandemic and will continue to make adjustments following state and federal laws, as needed," a spokesperson wrote. "As a system of locally operated companies, we are deeply committed to supporting each of the communities we serve as they continue to confront the COVID-19 pandemic. With a focus on ensuring access to and adoption of safe and effective COVID-19 vaccines, BCBS companies have set up and supported mass vaccination events, funded rides to vaccination sites, identified homebound individuals to ensure access to care, and shared accurate, trusted information on COVID-19 vaccines with vulnerable and underserved communities. To date, BCBS companies have invested more than $11.5B to address COVID-19 and helped vaccinate millions of Americans. To learn more about BCBS companies’ COVID-19 response and recovery."

Kaiser Permanente also responded. 

"Kaiser Permanente’s, policy of waiving out-of-pocket costs for COVID-19 testing and treatment ended on July 31, 2021, months after many other providers ended similar waivers," the company's spokesperson noted. "Starting in mid-March 2020, the policy had been to waive member out-of-pocket costs for treatment related to a positive COVID-19 diagnosis.  Members who were diagnosed with COVID-19 did not have to pay co-pays or other cost-share related to their medical care and treatment of COVID-19, even if that involved a stay in the hospital."

 The spokesperson continued, "When we instituted this policy, we believed that out-of-pocket costs should not be an impediment to any member seeking screening for the COVID-19 virus, or seeking treatment if they were infected. This was at a time when infections were growing exponentially in our communities. Testing and treatment benefitted not only those seeking those services, but also the community at large. Identifying, isolating and treating those with the virus helped control its spread to others. With the economy continuing to improve and vaccinations readily available, treatment is currently covered subject to the standard cost-share provisions of the member’s health plan (Except for Medicare members who will still enjoy $0 cost-share until the end of the Public.)"