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Cost-Sharing Waivers Did Not Cover All COVID-19 Hospital Care in 2020

Last Updated: October 27, 2021.

WEDNESDAY, Oct. 27, 2021 (HealthDay News) -- Many patients were billed for professional and ancillary services related to COVID-19 hospitalizations in 2020, suggesting that insurer cost-sharing waivers did not cover all hospitalization-related care, according to a study published online Oct. 18 in JAMA Network Open.

Kao-Ping Chua, M.D., Ph.D., from University of Michigan in Ann Arbor, and colleagues estimated out-of-pocket spending for COVID-19 hospitalizations in the United States from March to September 2020. The analysis included 4,075 hospitalizations (33.8 percent among privately insured patients) identified from a national claims database (IQVIA PharMetrics Plus for Academics Database).

The researchers found that 71.2 percent of privately insured patients and 49.1 percent of Medicare Advantage patients had cost sharing for any hospitalization-related service, including those billed by clinicians. Mean total out-of-pocket spending was $788 for privately insured patients and $277 for Medicare Advantage patients for hospitalizations. For facility services associated with hospitalizations, mean total out-of-pocket spending was $3,840 for privately insured patients and $1,536 for Medicare Advantage patients. For 2.5 percent of privately insured hospitalizations, total out-of-pocket spending exceeded $4,000 versus 0.2 percent of Medicare Advantage hospitalizations.

"The findings suggest that out-of-pocket spending for COVID-19 hospitalizations may be substantial if insurers allow cost-sharing waivers to expire," the authors write.

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