People with insurance could pay over $1,300 for COVID-19 treatment

Someone with health insurance from their employer could pay $1,300 or more out of pocket for treatment if they’re hospitalized with a severe case of COVID-19, the disease caused by the novel coronavirus, according to one analysis. Health researchers based that prediction off of the costs associated with hospitalization for pneumonia. “The thought is, how we treat pneumonia is going to look at lot like how we treat the coronavirus,” said Matthew Rae, associate director for the Program on the Health Care Marketplace at the Kaiser Family Foundation, who worked on the analysis. “Both are respiratory illnesses.

” The new coronavirus is spreading through the US, and several states have made emergency declarations. The World Health Organization has declared it a pandemic. Here are the basics: Rae and his co-authors analyzed a database of insurance claims for people enrolled in employer insurance plans. They found that the total cost of treatments for people on those insurance plans who were hospitalized with severe pneumonia with complications was, on average, around $20,000 — though it ranged from around $11,000 to around $24,000.

Insurers covered most of that cost, but the out-of-pocket expense for most people usually reached or exceeded $1,300. The analysis, though, only captured the costs associated with an insurance plan. “It doesn’t capture out-of-network billing charges,” Rae says — also known as surprise medical bills, which can happen when a doctor who isn’t in a patient’s insurance network stops by to see the patient. Around 18 percent of people with severe pneumonia end up with a surprise medical bill.

The costs for pneumonia treatment may not map exactly onto the costs for COVID-19 treatment. It doesn’t include the costs of protective equipment and isolation, for instance. “Those things will make it more expensive,” Rae says. It’s hard to estimate those costs, he says, because there isn’t much data in insurance claims databases that includes them.

This analysis would only apply to patients who are insured through employer plans, which tend to have low deductibles and be fairly generous. People insured with Affordable Care Act plans may face different out-of-pocket costs, Rae says. “It could really range,” he says. “But I wouldn’t say that it would be magnitudes different.