Study: After grace period, Medicare COVID-19 patients will pay average of $1,000 out-of-pocket for hospitalization

Insurance companies and government programs have voluntarily waived cost sharing for COVID-19 hospitalization, but patients may face significant out-of-pocket costs once these grace periods end, according to research published Feb. 17 in the American Journal of Preventive Medicine.

To predict out-of-pocket costs patients could face after insurance companies stop absorbing COVID-19 hospitalization costs, two healthcare researchers from the Ann Arbor-based University of Michigan and Boston University examined data from 14,278 Medicare Advantage patients hospitalized for influenza in 2018. 

These flu patients stayed in the hospital for an average of six days, and about one-third of them needed intensive care. Both measures are around the same or slightly lower than the averages for Medicare Advantage patients hospitalized for COVID-19.

Analysis of the flu-related hospital bills suggested patients hospitalized for severe COVID-19 could face an average out-of-pocket cost over $1,000 due to deductibles, copays and coinsurance. The researchers predicted patients who require intensive care or have longer stays at any care level will face out-of-pocket costs higher than the general average, as about 3 percent of the flu patients examined in the study faced out-of-pocket costs over $2,500.

Patients who have private non-Medicare insurance could face even higher costs, as private plans often have high deductibles that must be paid each year before coverage fully initiates.

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