“image The Cost of COVID-19 Treatment on U.S. Insurers and Patients - FBMC Benefits Management, Inc.
The Cost of COVID-19 Treatment on U.S. Insurers and Patients

March 24, 2021

Since the onset of the pandemic, COVID-19 testing and treatment remains a serious expense for insurance companies and patients alike.

One of the biggest changes for insurance companies, with the onset of the pandemic, was free testing. To help ensure early treatment and positive health results, the Families First Coronavirus Response Act made sure that all costs connected with testing would be free for everyone, whether or not they were insured. As part of national concern, insurance companies and the government are covering all costs associated with testing, but not treatment.

With a total of 695,000 tests done daily in July of 2020, there continues to be no cost to the individual. On the other hand, insurers pay anywhere from $20 – $850 per test1. Projections for the total cost of COVID-19 treatment depend on infection rate. Between a 10% – 60% infection rate means insurers may pay anywhere from $30 billion to $547 billion for COVID related services2.

The coronavirus pandemic has brought to light the wildly different prices labs, hospitals, and healthcare specialists charge for their services. So far there has not been any federal regulation on the costs of COVID-19 testing or any other related healthcare for private insurers1. The significant fluctuations in test prices, could mean a hike in premiums for the next year and beyond.

Furthermore, prices for COVID-19 treatment also vary widely depending on the provider. This means that whatever is not covered by insurance companies could become a large bill for the patient to pay thanks to “surprise billing”.

Many healthcare specialists set their own rates for providing services. A person’s insurer will have arrangements with “in-network” providers to pay a set amount for each procedure. If a patient uses services provided by an “out-of-network” provider, then the patient will end up paying the difference between the in-network allowed amount and the out-of network bill.

In times of emergency, a patient may not know or be able to request in-network providers and only find out after treatment that they will have to pay more than they anticipated. This is even more troubling as many people have lost their jobs and insurance coverage because of the pandemic.

To protect yourself, be a conscious consumer by using in-network providers and requesting to be referred to an in-network provider when possible.

1. Nisha Kurani, Karen Pollitz, Dustin Cotliar, Nicolas Shanosky, and Cynthia Cox. COVID-19 Test Prices and Payment Policy.July 15, 2020. Peterson-KFF Health System Tracker.
2. Robert King. COVID-19 Could Cost Insurers up to $547B through 2021: Report. June 8, 2020.Fierce Healthcare.