Do you have a plan for helping employees with high COVID-19 care costs?
There’s no doubt the cost of diagnosing and treating 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 comorbid conditions 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 was prohibited from billing patients for fees above its in-network reimbursement rate even if the care received was out of network. With the CARES act expiring July 31, 2020, unless it’s later extended by Congress, employees may face larger medical bills if they contract the virus.
And there are several other scenarios where employees 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 incur significant out-of-pocket costs. Those 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 employers can help employees deal with large medical bills
Employers can help employees prepare for and manage high healthcare costs related to COVID-19 as well as large medical bills related to other health conditions such as serious illness or accidents several ways.
1. Make sure they fully understand their benefits. Educating employees about what services are covered; how to ensure they’re using in-network providers whenever possible; what their deductible, copays and plan maximums are; and whether they need preauthorization for certain services can help them get the most out of their health benefits and lower their bills. If you offer an FSA or an HRA for a high-deductible plan, make sure they both understand how the plans can help them manage costs, which can encourage them to participate in the plans, and how to access the funds when they need them. You can also consider making employer contributions to their FSA and/or HRA to help lower out-of-pocket costs. This education should take place consistently throughout the year, so the message reaches as many employees as possible before they are facing a health crisis or high bills.
2. Help them be savvy healthcare consumers. Encourage employees to 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 employees end up with medical bills that they cannot immediately pay, help them find out how to request a payment plan. Key questions they should ask when setting up a payment plan include how long they have to pay their 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 they can pay off the balance before the end of the plan without penalty. Employers can also support employees in efforts to negotiate a lower cost for their 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 talk with employees about contacting the hospital to learn whether they qualify for financial assistance.
3. Provide the services of a medical billing advocate. Especially in cases where an employee or family member has been treated for a serious illness or injury and faces a long recovery, dealing with the financial aspects of their care can be stressful and overwhelming. By providing the services of a medical billing advocate as a benefit, employers can relieve this stress, help employees make sure their bills are accurate and provide professional assistance negotiating the lowest possible payment. In addition to helping employees financially and psychologically, providing the services of a medical billing advocate can also increase employee satisfaction with their benefits and strengthen loyalty to their employer.