Holes In Insurance System Leave Many Coronavirus Patients With Surprise Bills

By Consumers For Quality Care, on April 28, 2020

Holes In Insurance System Leave Many Coronavirus Patients With Surprise Bills

A recent NBC News article highlighted the problems with health insurance that millions of consumers are facing in the wake of coronavirus. As the virus spreads and patients seek treatment, they have often been met with a confusing system that can leave them with surprise bills.

One man, 25-year-old Christopher Hoffman, had all the “telltale” symptoms of the virus in early March before widespread shutdowns. He went to an urgent care and was diagnosed with pneumonia, but they would not test him for COVID-19.

“Because I didn’t have a fever, they didn’t think to test me for COVID-19,” Hoffman said. A week later, he was in the hospital on an IV.

Hoffman recovered, but now he faces big out-of-pocket expenses. Because he got sick before testing was more widespread, he is not protected by any of the government actions that have since been taken to prevent unexpected bills for seeking treatment from the virus.

Hoffman’s story is just one of many that are happening all around the country. Insurers and the government have vowed to make coronavirus treatment and testing free for anyone who needs them, but the fragmented nature of the U.S. health care system has seen people falling through the cracks.

Another man, Evan, has a wife who is a nurse. When she started showing symptoms of the virus, she decided to get tested. Even though she was not initially billed for the coronavirus test, the family received a bill for everything else, including the clinic visit and a flu test.

“We’ve been promised that the costs for testing and treatment are going to be covered,” Evan said. “Now I’ve got a $200 bill.”

The millions of uninsured in the U.S. are the most vulnerable to surprise billing. One woman, Anne Bakjian of Georgia, spent two weeks in a hospital fighting coronavirus before she was able to recover and go home. She soon found out the Medicaid program she was enrolled in would not be covering the costs of her treatment.

Weeks later, she received a statement indicating that her insurer, Peach State Health Plan, the Medicaid program for low-income Georgia residents, hadn’t paid her $48,000 hospital bill.

A representative for Peach State told her that the care wouldn’t be covered because it hadn’t been pre-approved, Bakjian said.

After NBC News got involved, Peach State Health Plan cleared Bakjian’s hospital bill.

Even if consumers escape the immediate costs of the virus, they may still pay down the road. One analysis found that insurance premiums were likely to increase by 40 percent in 2021 if regulators do not step in.