Importance of Medical Insurance during the Time of COVID-19

The entire world is facing the mayhem created by the COVID-19 pandemic and is dealing with the disruptions of unimaginable proportions. Coronavirus cases globally as per the WHO Report have crossed 1.3 million mark and are continuously growing. More than 5 Lakh people have lost their lives, truly testing time for the healthcare sector.

This pandemic is showing no signs of ebbing yet, and with no insight of clear end to this, everything seems to be quite complicated including the support and expansion from healthcare services, sustenance to the most impacted sections of the society, dealing with system-wide stress across the industry segments, and finding ways to reduce financial stress.

The medical inflation had been estimated to be in the double in the near future, and with the looming presence of coronavirus, these estimates seem to get only worse. As COVID-19 patients and their families find themselves dealing with exorbitant hospital bills, a health insurance policy with adequate coverage would minimize the out of pocket expenses during these unprecedented times. With millions of Americans losing their jobs due the worsening cases of the Coronavirus, it becomes all the more essential to buy health insurance coverage and be prepared for any such medical emergencies.

The increasing cost of healthcare and the rising need for health cover is expected to fuel the global health insurance market. As per the Data Bridge Market Research analyses, the Global health insurance market is expected to reach USD 2,259,670.09 million by 2027. The Asia Pacific health insurance market is also expected to reach USD 594,240.31 million by 2027.

Grappling Situation So Far

The Covid-19 coronavirus outbreak that started in China is now accelerating in other countries. WHO recently declared ‘Europe’ as the epicenter after China. The cases are constantly surging in the USA and the governments are reacting to it even in more dramatic ways, imposing travel restrictions, closing borders, imposing lockdowns, and banning mass gatherings. The governments in all the countries are also gearing to launch a COVID-19 vaccine to combat the community spread as soon as possible.

Check out the Positive Cases of COVID-19 around the World

(Source: WHO)

The numbers are perplexing.

A recent report by the Urban Institute mentions that more than 10 million Americans are also likely to lose health insurance coverage till December,2020 that is sponsored by their employers. The report further stated that 3.3 million people will regain health insurance coverage by being added to a family member’s policy, 2.8 million people will get enrolled in Medicaid, and 6 lakh people will enroll in the individual market. It will leave around 3.5 million individuals uninsured. And with increasing COVID positive cases and job losses, the number of workers losing their employer-backed medical insurance will also grow.

Cost Involved in Treatment of COVID-19 Positive Patients

The cost involved in coronavirus treatment may differ due to the fragmented health care systems. It largely depends on the type of insurance cover you have, the coverage benefits that it offers, and the percentage of deductibles that are involved.

A per the recent data revealed by the Kaiser Family Foundation, the average cost of COVID-19 treatment for an individual with employer insurance without complications can cost around USD 9700. Cases involving complications can soar the bill to USD 20,290. The research was based on the data examined for people hospitalized with pneumonia.

At this time, most private health insurance providers offer coverage to treat coronavirus complications, but it comes with deductibles (the amount that you need to pay from your own pocket). Nearly 80% of people rely on the corporate health insurance cover that has deductibles attached, which on an average can involve annual deductibles around USD 1,655.  Many medical insurance plans also require co-payment that can range around 15%-20%.

As per the research patients with both complicated and uncomplicated COVID cases, can expect out-of-pocket costs around USD 1,300. And to meet such exorbitant expenses, it makes sense to have a standalone health cover in addition to the one provided by the employer and if possible a COVID specific health plan that minimizes the out-of-pocket medical expenses.

Amid the increasing number of cases, more and more health insurance initiatives are being taken by local and global health insurers, as the market witnesses an increase in queries related to popular health insurance plans and requests by the millennials. The demand for coronavirus related health insurance plans has also seen a drastic shift in the South Asian countries including India.

The Indian Government has also taken initiatives to ensure health cover to maximum people. Standard medical insurance products catering to the pandemic have been introduced recently that also provide 5% discount on premium to all the healthcare workers. And the existing medical policies already cover the cost of COVID-19 treatment.

Important Role Medical Insurance Can Play During COVID Treatment

Uninsured people are facing the worst hit during this time of the pandemic, as the treatment involves a considerable amount of money. Most of the health insurance plans cover COVID-19 treatment just like other ailments. Therefore, health insurance plays a critical role in helping people deal with any kind of medical emergencies:

• Reduces out-of-the-pocket expenses- An average three-day hospital stay can cost you thousands of dollars. Whereas your health insurance policy reduces such costs for you. It offers essential health benefits including hospitalization, laboratory tests, outpatient care, prescription drugs, pediatric services, preventive services, and similar expenses
• Cashless Facility– Cashless treatment is available, which saves you from running pillar to post and focus on the treatment, without worrying about the massive bills that you will receive from the hospital
• Health Cover for Family– Individuals across different age groups can get insured along with their spouse and children. It ensures that the entire family get healthcare benefits in case of COVID-19 as well as other health emergencies
• Coverage for Retired People– If you are retired you cannot avail benefits from your employer’s health insurance. If you are eligible you can get yourself enrolled in Medigap, Medicare, or Medicare Advantage.

Health Insurance Initiatives So Far

Such health problems are not coming out of the blue, even when we are not withstanding a global pandemic, the Americans face uniquely high health care costs. Amid the COVID-19 crisis, an old problem now becomes urgent to handle, as many Americans could still face huge medical bills, or may seek to prevent those by avoiding diagnostic tests and medical treatment, which is more likely to worsen the outbreak of this virus.

The solution lies in increasing the penetration of medical insurance and predictable management of healthcare costs combined with the availability of granular data to manage the insurance portfolio. There is a higher possibility of such pandemic situations in the near future, and the need for universal health insurance cover is more pronounced than ever.  

As an initiative, Aetna, a CVS Health company in the USA, is waiving co-pays for all the COVID-19 related diagnostic tests. Blue Cross and Blue Shield of Massachusetts has already processed nearly one million tele-health claims to expand coverage for virtual visits at no cost to members during the pandemic.

United Healthcare is also waiving costs for COVID-19 testing at approved Centres as per the CDC guidelines, including waiving off co-pays, deductibles, and co-insurance for visits related to COVID-19 testing, for medical care received in an emergency department, physician’s office, and urgent care center.

Can you Buy COVID-19 Health Insurance if you don’t have a Health Insurance Policy?

Relying on your employer’s health insurance might not be a great idea in the current situation. It makes sense to buy a separate health insurance policy that covers COVID-19 along with other ailments. Or you can buy a Coronavirus specific health plan, but there are some important aspects that you need to consider before buying any of them:

• Check what all illnesses are covered in your policy
• Does the plan cover prescription drugs or only generic versions of prescription drugs?
• Look for the amount of deductibles, co-pay and co-insurance clause
• Check the policy term, avoid opting for a short-term policy that only lasts for 3 months
• The list of hospitals that are a part of the network

Take away

Monetary issues won’t be a constraint in fighting this deadly virus or any other illness if people have an adequate health insurance cover. It will help meet the massive hospitalization costs and ensure that people are not left uninsured and have access to the needed healthcare services. Universal health coverage has now become a major goal to bring health reform in many countries and a priority objective for the World Health Organization.