When Paul Moser thinks about getting a coronavirus vaccine, he also thinks about his outstanding medical debt: $ 1,200 from some urological visits he couldn’t pay for.
Mr. Moser, 52-year-old gas station cashier in New York State, has friends who have been surprised by bills for coronavirus testing, and fear the same could happen to the vaccine. At the moment he is holding back with his admission.
“We were told by lawmakers that all testing should be free, and then it’s surprising that it costs $ 150,” he said. “I agree that getting vaccinated is important, but I have no sense of urgency.”
Congress passed laws banning pharmacies and hospitals from charging patients for coronavirus vaccines. Signs at vaccination centers indicate that vaccination is free. From the start, health officials and government leaders have told the public it won’t cost anything. And there have been few reports of people being charged.
Even so, some unvaccinated adults cite concerns about a surprising bill as a reason not to get the vaccination. Many of them are used to a healthcare system where the bills are frequent, high, and often unexpectedly high.
A recent survey by the Kaiser Family Foundation found that about a third of unvaccinated adults were unsure whether insurance would cover the new vaccine and feared they would have to pay for the vaccine. Concern was particularly high among Hispanic and Black respondents.
“The conversations we have are like, ‘Yeah, I know it’s good. Yes, I want it, but I don’t have insurance, ‘”said Ilan Shapiro, medical director of AltaMed, a community health network in southern California that serves a large Hispanic population. “We’re trying to make sure everyone knows it’s free.”
The confusion may be due to a lack of information or a skepticism that a doctor’s visit will not be followed by a bill. Liz Hamel, director of survey research at Kaiser, said it might reflect people’s experience of the healthcare system: “People might have heard it was free but they don’t believe it.”
Congress has tried to protect patients from bills for coronavirus vaccines and tests. At the start of the pandemic, it ordered insurers forego co-payments and deductibles for both services and set up a fund to reimburse doctors who see uninsured patients.
Even so, patients faced bills for tests – some for over $ 1,000. Some doctors billed uninsured patients for testing instead of the new federal fund. Others have charged unexpected fees and services for the test visit.
The rules for billing vaccines have been tightened. In order to become vaccinated, doctors and pharmacies had to sign a contract in which they did not charge patients for vaccinations.
The stronger protection seems to have worked. While many patients have come across coronavirus bills for testing – the New York Times has documented dozens of cases in bills submitted by readers – there have only been a handful of vaccines.
Still, some unexpected charges have been flunked: Patients in Illinois, North Carolina, and Colorado have incorrectly received vaccination bills. In all cases, the vaccine providers have reversed the charges and apologized for the mistakes.
The federal government has received some complaints about unexpected fees and recently warned doctors not to bill patients.
Surprising bills for coronavirus vaccines, tests, and other medical supplies can make an impression on patients. According to a 2013 study by Lucie Kalousova by Lucie Kalousova, an assistant professor of sociology at the University of California, Riverside, Americans with medical debt are more likely to skip required care than people with other types of debt, such as outstanding credit card bills or student loans.
“For someone in medical debt, they may be told by the media and everyone else that the vaccine is free, but they have also had this very negative, previous encounter with the medical system that has generated suspicion. ” She said.
Some patients worried about the cost of a coronavirus vaccine said they always expect a bill after a doctor’s appointment. Quoting stories from friends or family members who ended up having expensive coronavirus tests and treatment bills, they wondered why the vaccine would be any different.
“This is America – your health care ain’t free,” said Elizabeth Drummond, a 42-year-old Oregon mother who is not vaccinated. “I just have a feeling that this is how the vaccination process will work. They will try to capitalize on it. “
It’s also possible that survey research is exaggerating how many Americans are afraid of receiving a surprise vaccine bill. When the Times conducted follow-up interviews with the help of Kaiser, some respondents expressing this concern said it didn’t matter much to them.
Instead, they said they acted like this to express their frustration with the vaccine or the general American healthcare system.
“Cost is the smallest detail,” said Cody Sirman, a 32-year-old who works in manufacturing in Texas who chose not to get vaccinated. He said he wouldn’t mind paying for the vaccine if he trusted him – but he doesn’t: “I think the vaccine is a complete farce. It was just a way to see how much control the government can have over the population. “
For many, the potential cost of a vaccine is only part of a set of reasons to stay unvaccinated. It can often be difficult for pollsters to pinpoint the determining factor – or even identify patients. Separate research by the Census Bureau last month found Americans were more concerned about vaccine side effects than potential fees.
“Most people don’t say they are only concerned about one thing; Usually there are many, ”says Ms. Hamel from the Kaiser Family Foundation.
Tiffany Addotey, a 42-year-old school bus driver in North Carolina, has concerns about the cost. This is mainly due to their experience of taking a coronavirus test.
“It worries me that some places were charging $ 200 for coronavirus testing,” she said. “I haven’t paid. I went home. I already have enough bills. “
There are other things that concern them, such as the safety of the vaccine given its rapid development, as well as Johnson & Johnson’s recent vaccination hiatus.
When Ms. Addotey was informed that federal law makes the vaccine free for all Americans, she replied, “So I just have to pay my co-payment?”
Learning that it was really going to be free, with no additional payment, “helped a little,” she said. But it wasn’t enough to reassure her with the vaccination, at least not yet.
“I’ll try and wait a little longer,” she said. “I feel like I’ll get it after a little more research and a little more time.”
