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Open Enrollment Warning: Your Health Insurance May Not Cover COVID Treatment

Several paramedics load a person strapped down to a gurney into a red ambulance parked on a residential street before transporting him to a hospital.
County of Los Angeles paramedics load a potential COVID-19 patient into an ambulance before transporting him to a hospital in Hawthorne, California on December 29, 2020.
AFP via Getty Images)
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The midst of a pandemic might be the worst time to not have health insurance. With open enrollment in full swing for many employers — and for Covered California (the state’s health insurance exchange) — let's take a look at how each policy handles COVID-19 treatment.

Federal law requires health insurance companies to waive costs for medically necessary COVID-19 testing and vaccination. COVID-19 treatment is another matter.

At the beginning of the pandemic, some insurers chose not to charge COVID patients for treatment, and a few have continued that policy as long as the public health emergency is in place. But most insurers are quietly returning to business as usual, treating COVID like it's any other condition.

Because insurers voluntarily waived those costs, they can decide when to reinstate them. As waivers expire, patients will incur more out-of-pocket costs, up to their deductibles and, potentially, even their out-of-pocket maximums.

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That means people hospitalized with COVID, the vast majority of whom are unvaccinated, could face staggering bills for their treatment.

While this may be an incentive for eligible people to get a free COVID-19 vaccine, the unvaccinated population also includes children who are too young or too medically frail for the shots. Then there are those who have “long COVID,” an umbrella term for a myriad of symptoms that some people experience for months after being infected and may require expensive therapies.

There are currently six states, plus Washington D.C., that have enacted requirements forcing insurers to waive the cost of COVID treatment. California isn’t one of them.

You’ll need to check the policy of each plan you’re considering to see how COVID treatment is covered, and whether you’ll have to share the cost.

You can also get the free COVID shots or a booster, if you’re eligible. Vaccinated people are five times less likely to get infected and 10 times less likely to get so sick they end up in the hospital, according to the Centers for Disease Control and Prevention.

What questions do you have about the pandemic and health care?
Jackie Fortiér helps Southern Californians understand the pandemic by identifying what's working and what's not in our health response.

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