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Navigating the health insurance system is often difficult and overwhelming, even in the best of times. For patients with long Covid, a relatively new condition that frequently leaves patients with a lengthy and unpredictable list of debilitating symptoms, it can be especially nightmarish. "Even if you remain on the same [health insurance] plan you had before Covid, you will probably utilize the health-care system more, whether it be more office visits, more prescription medications or even more medical devices," said Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation. Indeed, nearly half of people with long Covid reported increased medical expenses, according to a recent survey conducted by the Patient Advocate Foundation. The nonprofit, NPAF's sister organization, polled 64 people with the condition between 2020 and 2022. Meanwhile, 13% of respondents in the PAF survey said they'd experienced changes to their health-care coverage as a result of long Covid.
In all, one Harvard University researcher estimated that long Covid could leave patients with an extra $9,000 a year in medical expenses. Here's what you need to know about navigating health insurance with the condition.
Unemployed long Covid patients have coverage options
Even if you remain on the same plan you had before Covid, you will probably utilize the health-care system more. Caitlin Donovan spokesperson at the Patient Advocate Foundation
4. Sign up for a plan on the public exchange Long Covid patients who have recently become unemployed may also be able to get health insurance on the Affordable Care Act's marketplace. Losing your job triggers a 60-day enrollment period on the marketplace, where many of the plans are subsidized. "Fortunately, ACA insurers are not allowed to discriminate based on health," said Jonathan Gruber, a professor at the Massachusetts Institute of Technology and a former director of the health-care program at the National Bureau of Economic Research. "So having long Covid will not raise costs." 5. Explore Medicare eligibility Lastly, if you end up qualifying for Social Security Disability Insurance because of your long Covid, you may become eligible for Medicare, even if you're younger than 65, after a two-year waiting period. If you're already 65 or older when you lose your job, Medicare may be your best option for coverage, Donovan said. "Medicare comes with the benefit of an almost universal network, in contrast to marketplace plans," Donovan said, adding that delaying enrollment once you're eligible can also subject you to financial penalties.
Employed patients ought to review benefits
If your case of long Covid hasn't disrupted your employment and you remain insured at work, you'll want to make sure you're signed up in a robust plan, Donovan said. A more comprehensive workplace plan typically comes with a higher monthly premium but lower out-of-pocket expenses and more options, Donovan said. It's especially important, she added, that you get the most generous prescription drug plan, if your company offers a variety of them. Educate yourself as much as you can about your coverage, Donovan said, including information on providers and treatments that you might formerly not have considered. Long Covid patients, for example, often seek physical therapy and mental health services, she said. You'll also want to make sure you're up to date on your employer's paid time off and sick days policy.
Clinical trials are 'worth investigating'
Clinical trials, many of which are covered by health insurance plans, can be a great option for long Covid patients, Donovan said. "Long Covid is still new, so anyone who participates in a clinical trial will be contributing to our understanding of the condition and advancing our ability to treat it," she said.
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