Cost of surviving COVID: Long-hauler shares his bills with Contact 6

MILWAUKEE - A COVID-19 survivor in Milwaukee is still suffering symptoms more than a year after being discharged from the hospital, and his medical costs continue to stack up.

In a notebook titled "Ken’s COVID Journey," Charita Ross kept painstaking notes that detailed her husband’s fight against COVID-19. Today, her notes help to fill the month-long gap in Ken Ross’ memory.

"All the doctors, all the nurses," said Charita Ross, flipping through the notebook with Contact 6’s Jenna Sachs. "I learned a lot of the terminologies."

Ken Ross spent four weeks on a ventilator in March and April 2020. During that time, his heart stopped three times and doctors performed CPR to bring him back.

"That scared me beyond belief, " said Charita Ross. "His oxygen was undetectable. They thought he was gone."

In April 2020, Ken woke up to his wife’s voice over FaceTime.

"She said, '[Do you know] how long you’ve been there?’ I said, ‘I don't know, an hour?’ She said, ‘No.’ I said, ‘Well, a day?’ She said, 'No,’" said Ken Ross.

Ken Ross spent another month at Columbia St. Mary’s Hospital relearning how to eat and walk. He spent another eight months on oxygen.

"I was in a lot of pain, my breathing," said Ken Ross.

Even today, he says he’s constantly fatigued.

"The shortness of breath, the achiness in my knees, the numbness in my toes," said Ken Ross.

Ken’s medical costs were extensive. In one year, his insurer was billed $1,071,187.36. UnitedHealthcare negotiated the bill down to $345,967.83 and paid most of it. What Ken Ross ended up owing is a small fraction of the original cost: $4,785.75.

Still, the Ross’ were confused by the bill.

"Maybe I misunderstood, but I didn't think you could be billed for COVID," said Charita Ross. "How do you bill any customer for a pandemic?"

It’s true many insurers temporarily waived cost-share for COVID-19 treatment under their health care plans, but that doesn’t mean every person with a health insurance plan qualified. Ken did not.

Insurance analyst, Krutika Amin of the Kaiser Family Foundation (KFF) explains why several COVID-19 patients did not qualify for the waivers.

"It was really a patchwork of the time period and the plan that someone was enrolled in whether COVID-19 cost-sharing waivers were available to them," said Amin in a Zoom interview with Contact 6.

Patient advocate Debby Deutsch of Patient Care Partners argues that UnitedHealthcare’s website uses confusing language regarding cost-share waivers for COVID-19 treatment.

"It's so often very, very nebulous," said Deutsch. "It should not be this complicated. It should not be this hard to figure out. I do think that this is worth appealing."

UnitedHealthcare tells Contact 6:

"While COVID-19 tests and vaccinations have been covered at 100% under the CARES Act, treatment is covered under individuals’ benefits plans. We have reviewed Mr. Ross’s bill to ensure it was paid appropriately under his plan and in compliance with federal law. He does have the right to appeal, if he chooses."

Ken and Charita Ross say they’re grateful for that insurance did cover for his treatment. Still, they’re worried about the bills yet to come.

"It's a new year and we're going to accrue these copayments again," said Charita Ross.

Kenn Ross still sees several doctors for his COVID-19 long-hauler symptoms.

"I'm trying to get back but it's a slow process," said Ken Ross.

Ann Brewer of Patient Care Partners says COVID-19 long-haulers often report body aches, headaches and neurological problems. Research on how long those symptoms may last is changing daily.

"You may have shortness of breath, months, maybe years down the road," said Brewer.

Despite his bills, Ken Ross says he’s thankful for the doctors who saved his life, and to his wife for her support and her journaling.

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"It still gives me something to think about every day, how blessed I am to be here," said Ross.

The Ross’ are making partial payments on their bill but say they plan to file an appeal. Many health insurance providers did provide cost-share waivers for COVID-19 treatment earlier in the pandemic under their plans, but most of those waivers have expired.