By Walecia Konrad,
May 15, 2020

When Grace Thomas ran a high fever and had trouble breathing in March, she headed to the emergency room. With a history of asthma, the 26-year-old Denver resident was familiar with respiratory distress, but this was different.

Both the ER doctors and Thomas suspected COVID-19. Yet while Thomas was experiencing symptoms of the disease, including severe pain in her lungs, she didn’t receive a test for the virus. The reason: Thomas was never officially admitted to the hospital, so she didn’t qualify for one of the sought-after tests, which the hospital at the time was limiting to patients who had been admitted. Instead, Thomas was stabilized by ER staff and sent home to recover with a fistful of prescriptions.

Weeks later, Thomas is feeling much better, but is now dealing with a new problem — sorting through the bills from her ER visit to determine what she owes. The financial hit from her COVID-19 treatment is part of the impact of the coronavirus, which has not only infected about 1.4 million Americans but also left many with heavy medical bills.

And plenty of stress — it’s often unclear who is on the hook for paying for coronavirus treatments. That’s especially true for patients like Thomas, who weren’t able to get tested for the disease when they initially sought medical care.

“I’m still sorting through everything and trying to figure out what might be covered under new COVID rules and how it’s all going to work out,” she said. “This ER bill is pretty huge.”

Thomas said she got a “not very well itemized” statement from her in-network hospital, which shows about $1,200 in coinsurance charges for her ER treatment. Co-pays from prescriptions add another $200 to her costs. She expects she’ll also owe a $500 co-payment for any ER visits, although she hasn’t yet found the bill for that. And she wonders if she’ll be on the hook for two telehealth follow-up doctor visits.

Exactly what’s covered by insurance for COVID-19 patients with out-of-pocket health care costs is a mystery to plenty of patients like Thomas. The patchwork of initiatives from the government and health insurance industry may create as much confusion as relief for consumers.

“I wish there were a federal law that said it was illegal to give a bill to a patient during all this,” said Karen Pollitz, senior fellow at Kaiser Family Foundation. “But it all depends on who is taking care of you.”

Costs for patients hospitalized for COVID-19 may reach $20,000 per person, while individuals can expect to pay an average of at least $1,300 in out-of-pocket costs, according to a Kaiser analysis. Even patients who aren’t hospitalized may still face pricey medical bills for outpatient treatments, testing and ER visits that don’t end in hospital admission, health advocates said.

Fear of racking up heavy medical bills may be keeping at least some people from seeking COVID-19 treatment. About one in seven adults said they would avoid seeking medical care for a fever and dry cough due to concerns about costs, according to a recent study from Gallup and West Health.

Dozens of insurers, including Aetna, Cigna and Humana have waived some combination of co-payments, co-insurance and deductibles for COVID-19 treatments including hospital stays, according to America’s Health Insurance Plans, a trade group. But these waivers vary in what they cover, and not all people with insurance may be eligible.

In many cases, these waivers apply to treatment from out-of-network providers — an important consideration for patients in hard-hit areas where it may be impossible to limit your options to in-network care. Bills for out-of-network services are often the cause of surprise medical expenses.

Before the outbreak, several members of Congress were working on ways to eliminate surprise billing. Now, several patient advocate groups are encouraging lawmakers to deal with the issue for all patients in the next stimulus bill.

The pandemic “shines a bright light on just how broken our health system is,” said Emily Holubowich, vice president of federal advocacy for the American Heart Association. Patients with heart disease are at much higher risk for serious complications from COVID-19 and, in turn, expensive medical bills…

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