Contracting COVID on a short-term health plan? Good luck.
It's not just the high deductibles that will weigh on patients, but the lack of covered services related to treatment and testing.
Exemptions, exclusions and high deductibles mean short-term health plans could leave people with significantly less coverage than anticipated if they are infected with COVID-19.
The findings in a study from The Commonwealth Fund urge policymakers to consider whether the short-term plans with all their limitations will adequately meet consumers’ needs during the pandemic. The study also said states could prohibit marketing of the policies during the pandemic or require them to cover COVID-19 testing and treatment without cost-sharing.
Related: Brokers balk at short-term health plans
President Donald Trump touted the expansion of short-term health plans during his State of the Union address in February, noting the plans are often cheaper than those that are compliant with the Affordable Care Act. But the short-term health plans come with huge tradeoffs in the form of reduced coverage, according to the study released May 12.
Several plans reviewed in the study do not cover pre-existing conditions, nor pay for preventative or experimental treatment. That last limitation means the plans won’t cover immunizations, or COVID-19 treatments like hydroxychloroquine and remdesivir, which are not yet approved for routine use.
“Short-term plans often have major coverage gaps that would extend to COVID-19-related services,” according to the study, which noted that 11 of the 12 plans it reviewed excluded most prescription drug coverage and only covering limited inpatient prescriptions.
The study also found that nine of the 12 plans had deductibles ranging from $10,000 to $12,500 for a six-month period. It was also common that patients would have to have to pay separate ER deductibles and a 30% coinsurance payment.
“Half the plans set their out-of-pocket maximum at $20,000 or more for a six-month period,” according to the study. “Since the deductible does not count as part of the maximum, consumers may be left with $30,000 or more in bills for covered in-network services in the worst situations.”
None of the short-term plans reviewed cover pre-existing conditions, which means they would not cover a COVID-19 infection that occurred prior to purchasing the plan.
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