Strategies to help you manage the high cost of care for COVID-19

There’s no doubt the cost of the diagnosis and treatment of COVID-19 is high. Data collected by FAIR Health found costs that ranged from approximately $37,000 to more than $93,000 per patient, depending on age, location, and whether the patient had other health problems that increased the risk of complications from the virus. Early in the COVID-19 pandemic in the U.S., Congress passed the Coronavirus Aid Response and Economic Security (CARES) act. Part of that act provided emergency funding for hospitals. If a hospital accepted the funding, it wasn’t allowed to bill patients for fees above their in-network reimbursement rate even if the care they received was out of network. With the CARES act expired as of July 31, 2020 unless it’s extended by Congress, Americans may face larger medical bills if they contract the virus.

There are also several other situations where you may be confronted with significant costs for care even if the act is extended. For example, some patients who seek care in the emergency department for symptoms they suspect are related to COVID-19 but who are not tested for the virus could end up paying significant out-of-pocket costs. People with high deductible plans could be required to pay thousands of dollars out of pocket for care. In addition, though many health plan have waived copays and other costs for COVID-19 related care, many self-funded employer plans don’t include those waivers.

Three ways to plan for and manage large medical bills

The best approach to this situation is to take three key steps to prepare for and manage the high healthcare costs related to COVID-19. This advice also can help if you’re faced with large medical bills related to other health conditions such as a serious illness like cancer or a heart attack or an accident.

1. Make sure you fully understand your health plan benefits. Learning what services are covered, how to make sure you’re using in-network doctors, hospitals, and other healthcare providers whenever possible, what your deductible, copays, and plan maximums are, and whether you need preauthorization for certain services can help you get the most out of your health benefits and lower your bills. If you have an FSA or an HRA for a high deductible plan, find out what you can use the money for and what documentation you need for reimbursement.
2. Be a smart healthcare consumer. Carefully review all healthcare bills for errors and duplicate charges. That can be especially important on large bills and inpatient care bills. In fact, Equifax found that for hospital bills totaling $10,000 or more, there was an average error of $1,300. If you end up with medical bills that you can’t immediately pay, contact the provider and ask to set up a payment plan. You should ask how long you have to pay the bill, whether the provider will charge interest on the unpaid balance, if there are any fees associated with the plan such as late fees or set up fees, and whether you can pay off the balance before the end of the plan without penalty. You can also try to negotiate a lower cost for your care. Some effective negotiation strategies include requesting to pay the rates that insurers pay for the same care and requesting a discount for paying cash. Also, you may also want to talk to the hospital to find out whether you qualify for financial assistance.
3. Engage the services of a medical billing advocate. Especially in cases where you or a family member have been treated for a serious illness or injury and face a long recovery, dealing with the financial aspects of healthcare can be stressful and overwhelming. A medical billing advocate can take that stress off your shoulders. A billing advocate will check bills to make sure they’re accurate and provide professional assistance negotiating the lowest possible payment.