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Published: Aug 10, 2021 8 min read
Employee at reception desk of hospital handing over a medical form to a visitor
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As cases climb and lockdowns loom once again, everyone from doctors to Instagram influencers are frantically trying to convince Americans to get the COVID-19 vaccine. So far, the movement has focused largely on incentives — to get needles in arms, officials have promised free beer, discount concert tickets and even $100 payments to people who get vaccinated against the coronavirus.

But with the delta variant spreading and the overall vaccination rate sitting at just over 50%, some organizations are beginning to take the opposite approach. Rather than offering perks to the vaccinated, they're cracking down on the unvaccinated with fees, surcharges and special policies.

The COVID-19 vaccine is free, but refusing to get it may affect your finances. Here are five ways being unvaccinated could potentially cost you:

You could lose your job

Vaccine mandates are increasingly popping up as remote work winds down. Google, Walmart and Facebook have all announced that vaccines are required for certain employees to come into the office, but other companies are taking more drastic measures — in the form of zero-tolerance vaccine policies.

CNN, for example, recently fired three unvaccinated employees for coming into the office. A New Jersey hospital system terminated six people who refused a vaccine mandate for employees of certain levels.

Other companies are in the early stages and have given advance notice to workers that they need to get the jab or lose their jobs. The Durst Organization, a New York-based real estate company, will fire unvaccinated corporate employees starting Sept. 6. United Airlines will do the same on Oct. 25 (or possibly sooner, depending on when the vaccine gets full approval from the Food and Drug Administration).

And, yes, it's likely legal. The Equal Employment Opportunity Commission has said discrimination laws don't prevent employers from requiring workers who physically enter the workplace to get vaccinated as long as they provide reasonable accommodations for those who cannot due to disability, pregnancy or religion. In fact, more vaccine mandates could be on the way: Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, predicted the U.S. will see a "flood" of them once the FDA gives its full approval to the vaccine.

You could incur hospital bills

Contracting COVID-19 isn't cheap. According to estimates from FAIR Health, a nonprofit that analyzes health care costs using insurance claims, the average COVID-19 patient with no insurance costs a hospital $73,300. A privately insured COVID-19 patient at an in-network hospital costs an average of $38,221.

Those are the total charges, not what people actually pay. For that price point, we look to the University of Michigan, which found seven in 10 privately insured COVID-19 patients who went to the hospital in 2020 ended up on the hook for out-of-pocket costs. The average payment was $788 — a significant bill, given the oft-repeated statistic that some 40% of adults couldn't cover a $400 emergency expense with cash, savings or a credit card they'd quickly pay off.

Some insurers also offered waivers that exempted patients from paying fees associated with the coronavirus crisis, but many of them have expired. So while a 70-year-old man who made headlines when he got a $1.1 million bill for his COVID-19 hospital stay is definitely an outlier, COVID-19 treatment still can be expensive.

You could have to cover test costs

Although COVID-19 tests at community health centers and pharmacies are generally free, some companies are requiring their unvaccinated employees to pay for testing.

MGM Resorts announced in July that unvaccinated workers will have to pay $15 for weekly on-site tests or upload PCR test results from elsewhere. In Hawaii, unvaccinated state and county employees have to cover the cost of weekly tests if they can't find free options. (The federal government, on the other hand, has said it'll pony up to test its unvaccinated workers.)

An April analysis by the Peterson-KFF Health System Tracker found that COVID-19 diagnostic test prices at the nation's largest hospitals range from $20 to $1,419. The average price for those PCR coronavirus tests shakes out to $148 before insurance and other fees are taken into account. At-home coronavirus tests you can buy at CVS may be an option, as well, but at $12 per antigen test and $120 per PCR test, those can add up fast if you're taking them on a weekly basis.

You could pay more for college

Colleges and universities are all over the map on vaccine mandates; there's even a group pushing the Supreme Court to get involved. West Virginia Wesleyan College doesn't require students to be vaccinated, but those who aren't — or haven't sent the school proof — will have to pay a $750 fee for the fall semester. It's non-refundable and goes toward covering the cost of weekly surveillance testing.

Birmingham-Southern College says it's charging students $500 for the fall term "to offset continual weekly antigen testing and quarantining," but people who get fully vaccinated before the term starts get an immediate rebate. Students who get vaccinated after school starts are also eligible for a smaller rebate. (The Alabama attorney general's office has condemned the policy.)

These measures are in addition to schools offering college students financial incentives for vaccines. The University of Alabama will give all vaxxed students $40 in "Bama Cash," which they can spend on items like gas, laundry and pizza. Missouri State University is holding drawings with prizes like $400 textbook refunds, MacBook Pros and a package that includes "free tuition, housing, meals, books, supplies and a designated parking spot for an academic year."

You could pay extra for cruises

Getting on a boat and sailing away may sound great right about now, but you'll have to comply with cruise lines' strict coronavirus policies. For instance, unvaccinated Carnival Cruises passengers don't just have to present negative test results at check-in — they also have to take tests when the ship leaves and when they disembark. To "cover the cost of testing, reporting and health and safety screenings," Carnival charges $150 per person. Unvaccinated passengers leaving from certain locations also must show proof of a valid travel insurance policy that covers, at minimum, $10,000 in medical expenses and $30,000 in emergency medical evacuation fees.

Royal Caribbean has a similar travel insurance rule for unvaccinated customers. Depending on the length of the cruise, it also charges $136 or $178 per passenger over age 12 for testing.

Norwegian, meanwhile, sued Florida's surgeon general to be able to require proof of vaccination from passengers. A judge preliminarily sided with Norwegian on Sunday, causing the cruise line's president to issue a statement celebrating its intent "to sail with 100% fully vaccinated guests and crew, which we believe is the safest and most prudent way to resume cruise operations."

More from Money:

Joe Biden Wants to Pay People $100 for Getting the COVID-19 Vaccine

Colleges Are Giving Students up to $25,000 Just for Getting Vaccinated

Please Stop Posting Pictures of Your COVID-19 Vaccination Cards on Social Media