After the pandemic hit last year, many health insurance companies nationwide announced policies to cover out-of-pocket costs for Covid-19 patients.
Kaiser Permanente was among them, saying any members who got the coronavirus would not have to pay for virus-related treatments beginning on April 1, 2020.
The policy ensured that patients who caught the virus wouldn’t return home to exorbitant bills. But as vaccines have become readily available, some health insurance companies including Kaiser are rolling back their generous policies.
“With the economy making positive strides toward recovery and broad vaccination well underway, the cost impediment is no longer as acute as it was at the start of the pandemic,” company spokeswoman Laura Lott said in an email.
Some of Hawaii’s other major insurers like the Hawaii Medical Services Association and UHA are still paying for all Covid-related care.
Kaiser stopped covering out-of-pocket costs for Covid patients nationwide on Aug. 1, affecting about 190,000 members in Hawaii, Lott said.
Clarification: A previous version of this story said the change would affect Kaiser’s 260,000 Hawaii members. Kaiser clarified Monday that about 70,000 members who are on Medicaid and Medicare won’t be affected.
Kaiser isn’t the first health insurance company to make the switch. NBC News reported that in January, health insurer Anthem stopped paying out-of-pocket costs for coronavirus patients. Aetna followed in February, and UnitedHealth stopped providing Covid waivers for out-of-pocket costs in March.
Kaiser is now covering Covid-like any other illness, Lott said. Patients are responsible for copays, which range widely depending on the severity of the illness and the treatment needed.
She said patients hospitalized prior to Aug. 1 won’t owe anything for Covid care, and Medicare and Medicaid patients are exempt.
Kaiser Permanente will continue to cover out-of-pocket costs for Medicare patients, while Medicaid costs are covered by the program, Lott said. She added that a financial assistance program exists for families in need.
The Kaiser change applies to patients regardless of vaccination status. But people who are unvaccinated are far more likely to get seriously sick from the virus, end up in the hospital and die.
More than 61% of Hawaii’s population is fully vaccinated, and nearly 69% has received at least one shot. But vaccination rates vary widely based on geography, age and race.
Young people, rural residents and Native Hawaiians or other Pacific Islanders are far less likely to be vaccinated at this point in the pandemic, state statistics show.
Sticker Shock
The sticker shock for Covid hospitalization is no joke. MarketWatch reported last year that one Seattle Covid patient got a bill for more than $1 million after spending a month on a ventilator. The high cost of health care in the U.S. is one reason why medical debt is a leading cause of bankruptcy.
Even though Anthem stopped covering all out-of-pocket Covid costs for members, the health insurer still expects to spend $600 million on coronavirus-related care this year and expects costs to rise as vaccinations slow.
State officials repeatedly have emphasized the importance of vaccinations as the delta variant drives a surge in coronavirus cases statewide, stressing hospital capacity and overwhelming public isolation and quarantine facilities.
The vaccine is free and available to anyone aged 12 and up, regardless of their immigration status or health insurance status.
On Friday, the state reported more than 1,100 new cases, a pandemic record.
As the virus rages, some health insurance companies are continuing to cover coronavirus patient out-of-pocket costs.
HMSA, which has 757,000 members, plans to do so as long as the pandemic is a federal public health emergency. The Department of Health and Human Services is likely to renew the public health emergency until the end of the year.
“As a mutual benefit society owned by the people of Hawaii, we will take copayments out of our reserves to ensure the safety and security of our members, as we work to eliminate this threat from our entire community,” HMSA president and CEO Mark Mugiishi said in an email.
UHA, which has 57,000 members, is also covering all out-of-pocket costs for its members who get sick with Covid.
AlohaCare, which only covers people who qualify for Medicaid or both Medicare and Medicaid, said all its members’ Covid health care costs are fully covered under the public health insurance plans.
“In Hawaii, there are no plans to change those comprehensive benefits,” AlohaCare CEO Francoise Culley-Trotman said in an email. “In fact, in light of our current surge, we’ve ramped up our efforts to support our providers, which in turn ensures that our members receive the care they need.”
More than 420,000 Hawaii residents are enrolled in Medicaid, according to the latest available data.
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