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A Coverage Gap: Medicare Beneficiaries Without Medigap Plans Could Be Hit With COVID-19


Insurers have waived cost sharing for COVID-19 but that would not apply to Medicare beneficiaries who haven't purchased Medigap policies.

Insurers and the federal government had taken steps to insulate Americans from cost sharing related to COVID-19 testing and treatment, but the Kaiser Family Foundation (KFF) noted today that a group of 6 million seniors and young people with disabilities without supplemental Medicare coverage (Medigap)  could still be hit with large hospital bills. 

Moreover, a large proportion (39%) of these Americans without supplemental coverage have per capita incomes of less than $20,000 or less, according to a foundation analysis of 2017 CMS data.

The foundation's expert calculate that COVID-19 patients covered by Medicare who don’t have a supplemental policy will face, at a minimum, a $1,408 payment for inpatient care before they meet their deductible. If they need nursing home care, they will face additional bills.

Older people are disproportionately affected by COVID-19 infections that require hospitalization, so presumably some COVID-19 patients are in this financially vulnerable position.

Most, if not all, private insurers, including Medicare Advantage plans, have moved to waive cost sharing for COVID-19 care. Americans who are uninsured have also been insulated from COVID-19-related bills. The Trump administration said earlier this month that it will use some of the $100 billion earmarked for hospitals to cover the cost of COVID-19 patients without insurance.

The Kaiser experts noted that COVID-19 patients in high-deductible plans may also be facing a large expense if their insurer did not waive cost sharing.

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