coronavirus

Uninsured Americans Could Be Facing Nearly $75,000 in Medical Bills If Hospitalized for Coronavirus

Misha Friedman

Thanks to lawmakers, coronavirus tests are now free for all Americans. But if you do test positive for COVID-19 and require treatment, the hospital bills could easily cost Americans tens of thousands of dollars, even if you have insurance. 

Those who are hospitalized with coronavirus can expect to pay anywhere from $42,486 to $74,310 if they are uninsured or if they receive care that's deemed out-of-network by their insurance company, according to recent analysis by independent nonprofit FAIR Health

For those with insurance who are using in-network providers, out-of-pocket costs will be a portion of $21,936 to $38,755, depending on the cost-sharing provisions of their health plan. 

To determine the estimates, FAIR Health drew on its database of over 30 billion private health-care claim records, and on estimates of Medicare and Medicaid costs, to project U.S. costs for COVID-19 patients requiring inpatient stays using diagnosis-related groups associated with pneumonia. 

FAIR also ran a slightly different cost analysis of COVID-19 medical care using procedure codes associated with influenza and pneumonia. Using those metrics, FAIR found uninsured Americans with COVID-19 could pay an estimated average of $73,300 for a 6-day hospital stay, while insured patients could expect to pay a portion of the $38,221 average cost billed to insurers.

For many, the symptoms of COVID-19 are mild to moderate — similar to that of a severe cold or the flu — so they should be able to ride out their illness at home, even if they test positive for the coronavirus, says Kim Buckey of DirectPath, an organization that guides employees to make better health-care decisions.

For anyone with symptoms, call your doctor for advice. If you don't have a primary care physician, call your local urgent care clinic or hospital and let them know you believe you're experiencing symptoms, Buckey says.

This is also a good time to make use of any telehealth or 24-hour nurse hotline programs offered by your employer or health insurance company, Buckey says. "These may save you a trip to the doctor's office entirely, and at the very least will cost less than a trip to the ER," she says. 

FAIR Health found that the average charge for telehealth services was about $43 for those without insurance. Insurers were charged $34 for a 5 to 10 minute telehealth visit, which means insured consumers were left to pay some portion of that, depending on their plan.

If your case does turn severe and you're hospitalized, Buckey recommends having a friend or family member keep track of what tests you are given, what medication and treatment you receive and which doctors you see (and how often). "That information may be helpful when you receive your bill," she says. Especially some of these costs may be covered or waived.

Even if you're not able to have visitors, you can authorize a friend or family member to talk with your nurses and doctors over the phone to to get information on what treatments and medication you're being prescribed. Most hospitals have a medical authorization form that you fill out when you begin treatment. 

Experts stress that for most Americans, keeping costs down depends on staying healthy. You can take care of yourself by getting enough sleep, exercising and eating healthy. Make sure to wash your hands regularly throughout the day, disinfect hard surfaces, avoid touching your face and attempt to social distance as much as possible.

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