Before we get into actually dealing with COVID-19 related medical bills it’s important to note that if you think you might have the virus don’t wait, get tested. Your health is the most important thing. It’s a sad state of affairs when the fear of outrageous medical bills prevents people from getting medical treatment – but don’t let this be you.
Additionally – if you’ve been billed for COVID-19 related treatment, call us at 877-245-4244 or Schedule A Free Consultation with one of our experts to see how we can help you fight your bill.
Paying for COVID-19 Treatment
The average cost of a COVID-19 related hospitalization could be as much as $20,000. For those with no insurance, high deductible plans, or poor insurance this could be a very scary prospect to have all or most of this cost fall on their shoulders.
However, the Federal Government has taken steps to ensure that the burden of paying for life-saving and necessary treatment does not fall too squarely on the shoulders of individual patients.
The CARES Act signed into law on March 27, 2020 included provisions to reimburse hospitals for the cost of treating uninsured patients for COVID-19 AND prohibitions on billing those patients for any additional amount beyond what the government pays.
Many hospitals are experiencing extreme cash constraints as elective and necessary but non-emergent procedures are rescheduled and people are avoiding ER rooms as much as possible. The CARES act includes $100B in stimulus money to these hospitals to help them stay afloat during this time. A portion of this $100b will be used to reimburse COVID-19 related treatment as mentioned above.
Any hospital or medical provider that accepts any portion of these stimulus funds will get reimbursed by the federal government for treatment and is not permitted to bill uninsured patients for the additional costs.
On top of all of this, both President Trump and Vice President Pence have made it clear on numerous occasions that they don’t want people, including the uninsured, to have to pay for COVID-19 treatment out of pocket. While it is theoretically possible for a hospital to refuse to accept stimulus funds and government payments and then bill uninsured patients directly for the cost of care, it would put them on the wrong side of the federal government, the current administration, and popular opinion.
In an Oval Office Address on Wednesday, March 11th President Trump claimed that private health insurance companies had agreed to “waive all co-payments for coronavirus treatments, extend insurance companies for those treatments, and to prevent surprise medical billing.”
While the above isn’t fully true, insurance companies as a broad industry have only agreed to pay for all testing related to the Coronavirus, there are two key things to remember:
The first is that many insurance companies, including Humana, Cigna, United, and Blue Cross Blue Shield have agreed to waive all types of cost-sharing (deductibles, co-pays, and co-insurance) for COVID-19 related treatment. You can find an updated list of insurance company COVID-19 treatment policies here.
The second is that it’s clear from the President’s announcement that his administration will not look favorably on insurance companies that do force significant out of pocket costs to patients with COVID-19 related treatment. While this does not mean that insurance companies are legally required to provide coverage, not doing so will put them on the wrong side of the federal government, the current administration, and popular opinion.
Who Might Fall Through the Cracks
While the majority of COVID-19 patients will likely be adequately covered either by their ACA-compliant and/or employer sponsored insurance plan or by the federal government, there are a few situations where patients may fall through the cracks and receive significant bills for their care.
The first case will be accidental billings. Hospital billing departments process massive amounts of claims and inevitably some things fall through the cracks and get incorrectly billed, double billed, or billed to a patient instead of insurance. There will likely be mistakes made where patients are inadvertently billed for their COVID-19 related medical care despite the best intentions of the hospita.
The second case will be patients with health insurance plans that don’t step up to cover care. Most major ACA compliant plans have already stepped up and it’s extremely unlikely that employer sponsored plans would take the PR and employee satisfaction risk from not covering COVID-19 care. That being said, temporary insurance, travel insurance, medishare, limited benefit plans, and fixed price indemnity plans all have a history of looking for reasons to deny coverage (we’ve dealt with hundreds of cases of this nature) and tend to care less about public perception on how they act towards their members. Many of them have not yet currently stated that they will waive patient cost-sharing for COVID-19 care and it may be the case that they will not do so.
The third may be patients who are seen at hospitals that don’t accept stimulus funds (we say may here because we’re unsure how many, if any, hospitals are actually in a position to refuse stimulus funds). These few hospitals that don’t accept stimulus funds would then have to make the conscious decision to go against public sentiment and try to collect directly from patients for COVID-19 related care. We think this is extremely unlikely, but it is possible. After all, there are hospitals leading the charge in jailing people who have unpaid medical debt.
How to Fight if Something Happens
If you end up falling through the cracks and getting a significant bill for an unpaid medical debt, know that there is plenty that can be done.
The first step is to check to see if you are part of the group that was accidentally billed. Call the number on your bill and walk through this – pointing out that the bill is for COVID-19 related treatment and ask the person on the other end of the line whether billing for this was intentional. A key point to remember is that the person you’re talking to is not the person who made the decision to bill you. You want to get that person on your side – don’t attack them. Work with them to figure out what can be done to get the bill wiped.
If the hospital informs you that the charges are correct and believes they are in their right to bill you for these charges, you can take this to the public sphere. Write a letter to the CFO of the hospital and CC the billing department, financial aid department, and even your US Senators and Representative and the State Attorney General. Make it public that the hospital is billing you for COVID-19 charges and that you think they are doing so incorrectly. This type of publicity, especially with both political parties strongly against patients paying for COVID-19 charges, has a strong chance of getting your balances wiped.
An Interesting Note on Balance Billing
We’d be remiss if we didn’t point out that the Department of Human and Health Services may have banned balance billing entirely in the stimulus bill. As mentioned above, hospitals that receive stimulus funds are forbidden from balance billing COVID-19 patients. Guidance released states that “HHS broadly views every patient as a possible case of COVID-19.” If COVID-19 patients cannot be balance billed and every patient potentially has COVID-19 that would mean that no patient can be balance billed for their care.
It’s likely that there will be legal challenges from medical providers who have fought tooth and nail to prevent balance billing legislation from being enacted. However, this is something to keep an eye on as it’s potentially a big step forward in ending a major predatory practice of the US healthcare system.
If you think you might have COVID-19, don’t forgo testing and treatment. There are structures in place to minimize your financial burden.
That being said, there are still groups of patients that may end up falling through the cracks and being charged for COVID-19 treatment. If that happens, fight to get it ended.
If you’re being billed for COVID-19 treatment and are unsure of what to do – Contact Us today for a Free Consultation. Our billing experts are standing by to walk through your case and provide guidance.
Braden founded Resolve after experiencing first hand how unfair the system is for patients. Prior to Resolve, he built and ran Operations for a renewable energy company and then built and ran Product, Growth, and Operations for a VC-funded edtech company. He received his MBA from Dartmouth’s Tuck School of Business and BA in Philosophy from the College of William and Mary. When not trying to lower healthcare costs he can be found outdoors mountain biking, skiing, or hiking with his dog.