Medical care research and review : MCRROct 8, 2026

Health Care Costs and Patient Payments Before and After Long COVID Over Three Years in a Statewide Insurance Group

Updated Oct 9, 2026

Abstract

Patients with long COVID incurred an average of $79,777 in total expenditures over 3 years.

Expenditures increased approximately 6 months prior to the diagnosis, peaked just before, and returned to baseline within 6 months.
An excess spending of $21,597 per long COVID patient was observed.
Dual-eligible patients experienced the highest absolute expenditures but had the lowest relative increase in costs.
Medicaid patients had the lowest absolute expenditures but the highest relative increase in costs.
The financial burden for long COVID patients is notably concentrated around the time of diagnosis.

Simplified

The objective of this study was to quantify expenditures for long COVID (LC) before/after diagnosis and compare 3-year trajectories with similar patients without LC in claims. A retrospective cohort study was conducted using Colorado All Payer Claims Database multi-payer claims (October 1, 2020-August 1, 2024). Adults with ≥1 U09.9 code and 1-year continuous enrollment pre-index were followed 1 year pre- and 2 years post-index. Multipart models addressed right-censoring; clustered bootstraps produced confidence intervals overall and by age, sex, and payer. Sample: 25,229 LC and 126,089 comparison patients across commercial, Medicare, Medicaid, and dual coverage. LC patients averaged $79,777 total expenditures over 3 years and $5,158 in cost-sharing. Spending rose about 6 months before the index date, peaked just before the index date, and returned to baseline within 6 months; excess spending totaled $21,597 per patient. Dual-eligible patients had the highest absolute expenditures but lowest relative increase, whereas Medicaid had the lowest absolute expenditures and highest relative increase. LC patients had a substantial financial burden concentrated around diagnosis, highlighting broader, system-level implications for health care spending.

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Health Care Costs and Patient Payments Before and After Long COVID Over Three Years in a Statewide Insurance Group

Abstract

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