Most private insurers are no longer waiving cost-sharing for COVID treatment

Across the two largest health plans in each state and D.C. (102 plans), 73 plans (72% of 102 plans) are no longer waiving out-of-pocket costs for COVID-19 treatment. Almost half these plans (50 plans) ended cost-sharing waivers by April 2021, which is around the time most states were opening vaccinations to all adults. Of the 29 plans still waiving cost-sharing for COVID-19 treatment, 10 waivers are set to expire by the end of October. This includes waivers that tie to the end of the federal Public Health Emergency, which is currently set to expire on October 17, 2021, though may be extended. Another 12 plans state that their cost-sharing waivers will expire by the end of 2021. Two plans specified end dates for COVID-19 treatment waivers in 2022 and 5 plans did not specify an expiration date.

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All of the 102 plans we reviewed (two largest plans in each state) had waived cost-sharing for COVID-19 treatment at some point since 2020. (These health plans represent 62% of enrollment across the fully insured individual and group markets).

Many employers offering self-funded and fully insured health plans to their employees also reported waiving COVID-19 treatment cost sharing based on preliminary results from the 2021 KFF Employer Health Benefits Survey (EHBS), which was fielded between January and July 2021 with over 70% of the interviews completed before April 19th when vaccines became available for most adults. Since this survey was conducted earlier in the year, many of the waivers may have already expired by the time of this report.

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