Out-of-Pocket Costs during Summer

As Americans enjoyed the last of summer, they also paid out-of-pocket costs because of healthcare issues such as COVID, diabetes, and infertility. They shared their financial concerns, which varied depending on their type of health insurance.

• Affordable Care Act. An independent contractor got COVID during the summer surge. His Obamacare plan had a $2,000 deductible, so he decided to pay $24 for an at-home test because urgent care would be more expensive. (The federal government will make at-home tests available via the mail for free in September.)
• Medicare. A retiree was recently diagnosed with diabetes. She lived on a limited income so enrolled in a Medicare Advantage plan to control her monthly expenses, even though it meant a narrow provider network. The cost of her insulin was limited to $35 per month thanks to the Inflation Reduction Act.
• Employer-Sponsored Insurance. A couple was struggling to become pregnant. Their job-based health plans covered fertility testing but not treatment. In-vitro fertilization (IVF) costs as much as $25,000. They were evaluating their options and hoping that one of their plans would cover it soon.

The U.S. has several health insurance systems, which each have their own rules about covered benefits. These consumers may or may not have had the coverage they needed at a cost they could afford, but they were making informed purchasing decisions. In other words, these consumers were Mastering Health Insurance.

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