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Earlier in the pandemic, we found that the vast majority (88%) of people enrolled in fully-insured private health plans nonetheless would have had their out-of-pocket costs waived if they were hospitalized with COVID-19. At the time, health insurers were highly profitable due to lower-than-expected health care use, while hospitals and health care workers were overwhelmed with COVID-19 patients. Insurers may have also wanted to be sympathetic toward COVID-19 patients, and some may have also feared the possibility of a federal mandate to provide care free-of-charge to COVID-19 patients, so they voluntarily waived these costs for at least some period of time during the pandemic. Our subsequent analysis found that several of these insurers were starting to phase out COVID-19 cost-sharing waivers by November 2020.

In the last few months, the environment has shifted with safe and highly effective vaccines now widely available. In this brief, we once again review how many private insurers are continuing to waive patient cost sharing for COVID-19 treatment. We find that 72% of the two largest insurers in each state and DC (102 health plans) are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October.

Nearly three-quarters of the largest health plans are no longer waiving cost-sharing for COVID-19 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.

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).

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