How Much Does COVID-19 Medical Care Cost? Nobody Really Knows
Unknowns about COVID-19 abound, including what the best treatment is and how much it will cost people who need it.
The severity of COVID-19 is different for every person who gets it, which makes it hard to know what an average cost of medical care would be.
Symptoms can be like a mild cold, or they can be severe enough that patients need invasive intubation and time on a ventilator. The less severe cases can be treated at home with over-the-counter treatments, said Dr. Rebekah Sensenig, an infectious disease specialist at Riverside Medical Group in Newport News.
According to the Kaiser Family Foundation, a nonpartisan organization that tracks national health care data and policy, the cost of COVID-19 treatment for people with employer health care plans could range from $9,000 to $20,000. The foundation looked at the average cost of pneumonia treatment and hospitalizations across the country. COVID-19 can cause pneumonia and can require many of the same interventions as pneumonia.
"Those covered by employer-sponsored plans can expect to have copayments and deductibles associated with coronavirus testing waived by their insurers, but will still be responsible for the out-of-pocket costs associated with their treatment," the foundation's website said.
Right now, there is no cure for COVID-19, Sensenig said. But there are options for people who are hospitalized with the illness to participate in drug trials. In that case, patients are incurring costs associated with hospitalization.
“[The trial drugs] would all be given at the hospital,” Sensenig said. “The ones that we have access to would be the hydroxychloroquine -- that one's readily available in the U.S. although there have been some shortages since COVID-19 started.”
Hydroxychloroquine is commonly used to treat lupus, an autoimmune disease. The Federal Drug Administration hasn't approved it for use to treat COVID-19.
The FDA has said it’s prioritizing COVID-related trials. That includes approving trials and reviewing results from those trials.
Sensenig said there are other medications that show some early promise, including one normally used to treat rheumatoid arthritis. The medication reduces inflammation in people who experience acute respiratory distress syndrome, or ARDS, which can be fatal.
But those medications are in short supply because they weren’t manufactured in bulk, Sensenig said. And now, with the outbreak, the drugs are in higher demand.
Final Bills Still Unknown
Bon Secours hospitals announced they would suspend payment of any treatment related to COVID-19. Spokesperson Jenna Green said in an email the hospital system will still bill patients’ insurance if they have it, but want to wait to collect payment until details are finalized “with insurance companies, lab partners, state and federal governments.”
Optima Health, the insurance company owned and operated by Sentara, announced in an email to policy holders it would waive costs associated with testing and treatment of COVID-19 until June 7.
In March, President Donald Trump signed a law that would extend free COVID-19 testing to people who use Medicare, Medicaid, other government-subsidized plans and most private plans.
The legislation provides for uninsured people by allowing states to enroll more people in Medicare and gives more money to a federal fund for health care entities to tap for reimbursement after treating uninsured people.
But the law doesn't protect against balance billing practices. Balance billing is when a provider charges the patient for the difference between the actual cost of care and what the insurance company pays for it. It can result in unexpectedly high bills when providers and insurance companies disagree on reimbursement rates for procedures and treatment.
Days before signing the bill, Trump said in a speech he “met with the leaders of health insurance industry who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments and to prevent surprise medical billing.”
But the practice persists, pandemic or not, said Jill Hanken, an attorney at the Virginia Poverty Law Center.
"If you end up in an out-of-network facility in an emergency, your health insurance should cover you for that emergency service after you pay deductibles and co-insurance because it's an emergency," she said. "And even sometimes if you go to an in-network hospital, you may be treated by someone who's not a provider on your plan and that's when people get large, surprise bills."
Hanken said the Virginia Poverty Law Center is concerned about people getting the care they need. The problem is critical as more people lose employer health insurance because of layoffs.
Virginians who meet the income requirements can apply for state Medicaid coverage.
If someone is laid off, they have 60 days from their last day of work to seek coverage through the federal marketplace, Hanken said.
Bon Secours Health System, Sentara Healthcare and Riverside Health System are among WHRO Public Media's corporate sponsors.