LONG COVID added little sustained health care use or Medicare spending beyond 3 months in older adults.
A large cohort study of traditional Medicare beneficiaries found that symptom diagnoses, facility-based health care utilization, and spending increased sharply during acute COVID-19 but declined substantially over the following weeks. By weeks 13 to 40, differences between beneficiaries with COVID-19 and matched controls were minimal.
Long COVID Medicare Spending Declines Over Time
The analysis included 937,077 Medicare beneficiaries with a documented COVID-19 diagnosis and 4,808,573 matched beneficiaries without COVID-19. Most participants were aged 65 years or older, and outcomes were assessed across the original, Alpha, Delta, and Omicron variant periods.
During the week of diagnosis, Medicare spending was an adjusted $7,933.13 higher among beneficiaries with COVID-19 than among matched controls. The average weekly difference decreased to $232.31 during weeks 1 to 12 and $28.21 during weeks 13 to 40.
These patterns were broadly consistent across the four COVID-19 variants, although small differences remained. In weeks 13 to 40, excess weekly spending ranged from $24.32 for Delta to $60.15 for Alpha.
Symptom Diagnoses Approach Control Levels
Beneficiaries with COVID-19 were 41.71 percentage points more likely to receive at least one diagnosis associated with postacute COVID-19 symptoms during the diagnosis week. This difference declined to 5.22 percentage points in weeks 1 to 12 and 1.94 percentage points in weeks 13 to 40.
The assessed symptoms included fatigue, respiratory problems, cognitive impairment, chest pain, sleep difficulties, pain, mood changes, and impaired mobility. The authors noted that Medicare claims may underestimate long COVID because symptoms are not captured unless beneficiaries seek care and receive a diagnosis.
Health Care Utilization Shows Similar Pattern
Facility-based health care utilization, including hospitalizations, emergency department visits, and hospital outpatient visits, was 1.78 visits higher during the diagnosis week. The average difference fell to 0.05 visits per week during weeks 1 to 12 and approximately 0.03 visits during weeks 13 to 40.
The findings suggest that the additional health care burden associated with COVID-19 among traditional Medicare beneficiaries was concentrated in the acute phase. However, the results may not apply to Medicare Advantage beneficiaries, younger populations, uninsured individuals, or people whose infections were not documented in Medicare claims.
Reference
Ghosh K et al. Postacute COVID-19 symptoms and health care utilization and spending among traditional Medicare beneficiaries. JAMA Netw Open. 2026;9(7).
Featured Image: fizkes on Adobe Stock.
- Author:
