With the rising costs of healthcare and the financial impact of chronic illnesses such as long Covid, it is crucial for individuals to navigate their health insurance effectively. This article will discuss strategies for avoiding unforeseen medical costs and the importance of understanding your insurance plan.

Understanding CPT Codes and Billing

One way to avoid unexpected medical costs is to familiarize yourself with the “Current Procedural Terminology (CPT) code” for any procedure or test you’re scheduled to undergo. This code is a standardized system used by medical providers and insurers to identify and bill for specific medical services. Knowing the CPT code can help you estimate the cost of a procedure and double-check your billing for accuracy.

The Financial Impact of Long Covid

Long Covid affects as many as 23 million Americans and is expected to have a financial impact rivaling or exceeding that of the Great Recession. The chronic illness will cost the U.S. economy $3.7 trillion, with extra medical costs accounting for $528 billion. Individuals with long Covid can face an average of $9,000 a year in medical expenses, with costs ranging from $3,700 up to almost $14,000. These costs can be much higher depending on the severity of the illness and its impact on a person’s ability to work.

Employer-Sponsored Insurance and Rising Premiums

Health insurance is an important benefit for employees, with 163 million nonelderly Americans covered by employer-sponsored insurance (ESI). However, many people with private coverage say that costs have prevented them from seeking needed medical care. ESI premiums have risen above the rate of inflation and have outpaced wage growth, with the rising price of healthcare responsible for approximately two-thirds of per-person medical and pharmacy claims spending growth. Private insurance plans pay 224 percent of Medicare rates for hospital inpatient and outpatient services, contributing to the financial strain on employees.

High-Deductible Health Plans and Policy Actions

A growing proportion of ESI plans require beneficiaries to pay a deductible, and the average deductible is rising. Employers are increasingly offering high-deductible health plans (HDHPs), which can lead to higher out-of-pocket expenses for individuals. Policymakers are beginning to take action to address the growing costs of health insurance, but it is essential for individuals to understand their insurance plans and take steps to minimize unforeseen medical costs.