Post #949: Insurance coverage of masks.

Posted on January 13, 2021

This is a brief note on a rather silly Washington Post article.  The article is here.

The Post article raises an important point:   Why doesn’t your insurance (or your health savings account or flexible spending account) cover the cost of your masks?

The reason I call it silly is that the cost of masks is trivial, as health care expenses go.  It’s hard to think of a legit health care expense that can be measured by dollars in the single digits.  So it didn’t really catch my eye for that.

It caught my eye because I’d just finished writing a post on the German health care system and provision of N95 masks (Post #945).  There, the government is not just providing masks via their insurance plans, it’s providing FFP2 (equivalent to N94) masks.

This is the first article I’ve seen that brought up the idea that maybe insurance and Federal insurance policy ought to be involved in the provision of masks.  And it gets full credit for that.

But my point is that anybody can cheaply buy a run-of-the-mill mask.  What you can’t get, as Joe or Jane Citizen, is a good mask — an N95 respirator.  Those were removed from standard retail channels early on, when we had a shortage of N95s..  And now that there’s no shortage?  Those are still largely barred from those retail channels.

I managed to pick up a bag of 50 Kimberly-Clark duckbill-style N95s on Amazon a month ago (Post #918). And I’ve already gone through about half the bag.  Not wearing them, because near as I can tell, they’re good for about eight hours of wear each (explained below).  So I’m just at the point of throwing away my first one.  I’m halfway through the bag by giving them to friends who cannot otherwise get their hands on an N95.

And so, I think government policy and insurers could play a major role in the area of masks.  Not by reimbursing the cost of a cheap mask.  But by getting every citizen — or every high-risk citizen — a few good masks.  By which I mean, N95 respirators.

How can you tell if an N95 is worn out?

Finally, as an aside, how do you know when your N95 is worn out?  The answer is, they eventually clog to the point of being hard to breathe through.  I read about this on a mask distributor’s website, and didn’t believe it until it happened to me.  My original 3M N95 dust mask finally bit the dust — after replacing the elastic one time — when it did, in fact, become noticeably hard to breathe through.  But that must have been at least 80 hours of use.

How do you tell that they’re hard to breathe through?  Put on a new one, and compare to the old one.  Notice a difference?  Then chuck the old one.

Usually, the elastic wears out long before that happens.  And so, by reputation, 3M 95s “wear out” when the elastic will no longer hold the mask firmly against the face.  The actual filtering material is typically nowhere near its limit.  But the mask (actually, respirator) has to be retired because it will no longer form a tight seal against the face.  (Unless you’re a cheapskate like me, and will replace the elastic.)

These Kimberly-Clark duckbill respirators have far thinner material than the 3M respirators.  (And cost far less as well, so that’s fair.)  They are much closer to what I would guess is a true disposable, wear-it-for-a-day-and-toss-it mask.

Unsurprisingly, after what I judge to be around 8 hours of wear, the Kimberly-Clark mask is behaving differently.  It collapses and expands to its full extent with each breath now, whereas it didn’t do that originally.  So it’s time to chuck the old one, and break out a new one.

For about a buck apiece, I have gotten more than fair value there. 

And I really have to think that my health insurance company has gotten fair value, as well.  And that they ought to be doing whatever they can to encourage their enrolled population to trade in their cheap blue ear-loop disposable masks for a quality N95 respirator.  And for the life of me, as a big believer in the intelligence of markets, I’m not quite sure why I’m not seeing that happening yet.

Those are slated to be back in stock on Amazon as noted in the graphic at the top of the post.