Do you have an extra $1,000 laying around? Due to changes in how insurance companies and the federal government are approaching COVID-19 treatment, you may soon need to find it.
When the pandemic hit, the government and nonprofit insurance companies in Minnesota came together to make sure the cost of testing and treatment didn’t get in the way of someone getting the help they need if they got sick with COVID-19. An agreement was struck to put a hold on the practice of “cost-sharing” when it came to COVID-19 testing and treatment.
Cost-sharing is what it sounds like: If you see a doctor in a clinic or hospital, get a test, or pick up a medication, you “share” the cost of that with your insurance company on top of your monthly premium. Not all health insurance plans have this, but many do.
In addition to the hold on cost-sharing, the federal government has paid for all COVID-19 vaccines and the cost to give the shots as well as setting up a fund through the Health Resources and Services Administration (HRSA) to cover the costs of testing, treatment and vaccination if you were uninsured. As a result, most folks have come to expect to not be billed for health care related to COVID-19.
But that is not how health care is “normally” delivered in the U.S., and with the push to “go back to normal” we are seeing these costs return. Earlier this year, nonprofit insurance companies in Minnesota started treating COVID-19 like other illnesses—if you get sick with COVID-19, you may have to share in the cost of your treatment.
If that requires a trip to the doctor’s office, you could be looking at a bill around $1,005 according to an analysis in the fall of 2021 by FAIR health. End up in the hospital for a couple days? That average number bumps up to $21,659. End up in the ICU? Now we are talking about bills coming in around $106,783.
And those are numbers for folks with insurance. Without insurance, those numbers are estimated to double. That’s bad news because this month the federal HRSA program to cover costs for uninsured individuals ran out of money.
Negotiations in Congress to provide more funding for the federal government’s COVID-19 response have stalled, and the last round of proposals did not appear to include funding to cover the uninsured program.
The good news is that in Minnesota the legislature authorized COVID-19-specific coverage for uninsured Minnesotans through our state Medicaid program. This program covers testing, diagnosis, vaccination, and treatment related to COVID-19.
You must be a resident of Minnesota and a U.S. citizen, U.S. national, or have a qualifying immigration status to qualify. However, this program is only in effect as long as there is a federal public health emergency declaration. Once that ends, which could happen this summer, uninsured Minnesotans will have few options.
Millions could lose coverage
The end of the federal public health emergency won’t just impact uninsured individuals seeking care for COVID-19. Thousands of Minnesotans could also lose their health insurance as a result. Since Congress passed the initial CARES Act, state Medicaid agencies have stopped the process of requiring people to renew or re-enroll to get coverage.
Once enrolled during this time, you stayed enrolled unless you choose to end your coverage. This is tied to the federal public health emergency, and so once that ends, states—including Minnesota—will have to go back to re-verifying and re-enrolling members.
This administrative process is estimated to result in millions of people in the U.S. losing their healthcare coverage, with a study by the Georgetown University Health Policy Institute’s Center for Children and Families estimating 6.7 million children, particularly Black and Latino children, among them.
Avoiding the hit
So what can one do to avoid the hit to one’s pocketbook from these changes?
First, make sure you are up to date on your vaccinations—all of them, including and especially COVID-19. During the omicron surge this January, the Centers for Disease Control (CDC) found that unvaccinated persons were four times more likely to get COVID and 23 times more likely to end up hospitalized than people whose COVID-19 vaccination was up to date (i.e. including a booster). For the time being, vaccination remains free and easily accessible (check out vaccines.gov).
Second, stock up on free at-home COVID-19 tests and high-quality masks while you can. Every home in Minnesota is eligible to order two rapid at-home COVID-19 test kits (four tests total) for free, while supplies last, from the State. They will be shipped directly to your home (visit https://mn.gov/covid19/get-tested/at-home).
This is in addition to the two sets of four free at-home tests you can get from the federal government by visiting www.covid.gov You can also find places offering free masks at covid.org.
If you have health insurance, you are also still eligible to get tests through your insurer each month for free depending on the type of insurance you have, so check with your insurer, too. Having plenty of at-home tests and high-quality masks on hand ahead of the next COVID-19 variant surge can help you and your family plan activities and keep the virus from spreading further if someone does get sick.
Third, make sure your contact information is up to date with your health insurance company, especially if you get your insurance through the State’s Medicaid or MinnesotaCare program. This will help you stay informed of when you or your child will need to renew their insurance so no one loses their coverage that shouldn’t.
As much as we are all tired of dealing with COVID-19, this virus doesn’t care how we feel. It is still out here making folks sick and landing them in the hospital or worse. Moving back to “normal” means we will have to face the realities of what it will cost us, from our health and our wallets, if or when we or a loved one gets sick with COVID.
Dr. Nathan T. Chomilo is the medical director for the State of Minnesota’s Medicaid/Medical Assistance & MinnesotaCare programs and practices as a general pediatrician in Brooklyn Center with Park Nicollet. He is a board member of the Minnesota Chapter of the American Academy of Pediatrics and an adjunct assistant professor of pediatrics at the University of Minnesota Medical School. He lives in Minneapolis with his wife and son.