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Costs for COVID-19 High With Consumer-Directed Health Plans

Out-of-pocket costs high for consumer-directed health plan enrollees, especially younger individuals

MONDAY, June 22, 2020 (HealthDay News) — COVID-19 hospitalizations could result in high out-of-pocket spending for commercially insured consumer-directed health plan enrollees, according to a study published online June 15 in the American Journal of Preventive Medicine.

Matthew D. Eisenberg, Ph.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues compared out-of-pocket spending associated with respiratory hospitalizations for conditions similar to those caused by COVID-19 between those enrolled in consumer-directed health plans and those with traditional, low-deductible plans using deidentified administrative claims from the OptumLabs Data Warehouse for Jan. 1, 2016, to Aug. 31, 2019.

The researchers found significantly higher out-of-pocket spending for commercially insured consumer-directed health plan enrollees compared with traditional plan enrollees (average out-of-pocket spending: $1,961 versus $1,653); among younger populations, these differences were largest (for persons aged 0 to 21 years: $2,237 versus $1,685). The largest difference in out-of-pocket spending was seen in the first quarter of the year ($2,578 versus $1,978) and persisted into the second quarter ($1,798 versus $1,580).

“Congress is now debating whether or not to require all plans to waive cost sharing related to COVID-19 treatment,” Eisenberg said in a statement. “Our findings suggest that they might want to take action to broaden cost-sharing waivers to include these self-insured plans, because those out-of-pocket costs are otherwise going to be high for many people.”

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