The cost of a coronavirus-related hospitalization for people with job-based health insurance could exceed $20,000, according to an analysis by the Peterson Center on Healthcare and Kaiser Family Foundation.
While employers would pick up most of that tab, employees could face out of pocket costs of nearly $1,500, researchers estimated.
Many health insurers have agreed to eliminate copays and deductibles for COVID-19 screening and lab tests. But employers and patients may still be on the hook for the much greater costs of treatment or hospital stay, if needed.
The researchers estimated those costs by analyzing the average price of a hospital admission for pneumonia, including pneumonia caused by a similar coronavirus, among about 18 million people under age 65 in large employer health plans.
They found that the average cost between the employer and employee of a hospital admission for pneumonia with major complications or in a patient dealing with multiple chronic diseases totaled $20,292 in 2018. Costs varied significantly across the country, ranging from roughly $11,500 to $24,200.
The average cost of a pneumonia admission was lower for patients with less serious complications and chronic conditions at $13,767 and without any complications or other chronic conditions at $9,763.
Employees wouldn't pay the entire cost, but they would be on the hook for a piece of it. According to the Kaiser Family Foundation, 82% of people with job-based coverage have a deductible that they must hit before insurance kicks in, and more than half of workers have a deductible of over $1,000. After a patient hits the deductible, they still may have to pay out-of-pocket costs, such has a copayment or coinsurance.
Patients' average out-of-pocket costs for a pneumonia admission ranged from $1,300 to $1,464 in 2018, depending on whether the patient had complications or multiple conditions.
The analysis noted that patients' costs could be even higher for patients with private coverage through small businesses and the individual market, where coverage tends to be less generous. The estimates also do not account for balance billing, which could occur if a patient sees an out-of-network provider. The brief estimated that nearly one in five patients who have in-network admissions for pneumonia with major complications or comorbidities face out-of-network charges.
