The New York Times is investigating the costs associated with testing and treating the coronavirus and how the pandemic is transforming healthcare in America. You can read more about the project and submit your medical bills here.
President Trump spent three days in the hospital. He came and went by helicopter. And he received multiple coronavirus tests, oxygen, steroids, and experimental antibody treatment.
For someone who is not a president, that would cost more than $ 100,000 in the American healthcare system. Patients could face significant surprise bills and medical debts even after their health insurance portion has been paid.
The greatest financial risks would come not from the hospitalization but from the services provided elsewhere, including helicopter transit and repeated coronavirus testing.
Mr Trump has praised the high quality of care he received at Walter Reed National Military Medical Center and downplayed the risk of the virus. "Don't be afraid of Covid," tweeted Mr. Trump on Monday before returning to the White House. "Don't let it dominate your life."
Across the country, patients struggle with both the long-term health and financial effects of contracting coronavirus. Almost half a million were hospitalized. Routine testing can lead to thousands of dollars in uncovered costs. Hospital patients have received bills for $ 400,000.
Mr Trump didn't have to worry about the cost of his care, which is covered by the federal government. Most Americans, including many health insurers, worry about medical care they cannot afford.
For some Americans, the bills could go up with frequent testing. Insurers generally have to pay for these tests when doctors order them, but not when employers do.
The Trump administration made this clear in June when it issued guidelines that insurers do not have to pay for "tests to check general health and safety in the workplace." Instead, patients have to pay for these types of tests themselves. Some may be able to get free testing in public locations, and some employers may voluntarily pay for it. Others could face significant medical debt from testing in hospitals or emergency centers.
Covid tests can be expensive. Although they typically cost $ 100, a Texas emergency room charged up to $ 6,408 for a drive-through test. About 2.4 percent of the coronavirus tests billed to insurers leave the patient responsible for some of the payment, according to health data company Castlight. With 108 million tests done in the US, that could equate to millions of tests where patients are responsible for some of the cost.
Marta Bartan, who works as a hair colorant in Brooklyn, needed a coronavirus test to get back to work this summer. She received a bill for $ 1,394 from the hospital that operates the transit station where she was tested.
"I was so confused," said Ms. Bartan, challenging the bill. “You do a Covid test and expect it to be free. What could they possibly have charged me $ 1,400 for? "
The bills for the typical American would continue in the hospital, with the routine monitoring each patient would receive and the medication provided as the care progressed.
Remdesivir, a new coronavirus treatment developed by Gilead, costs $ 3,120 when purchased through private insurers and $ 2,340 with public programs like Medicare and Medicaid.
Mr. Trump also received experimental antibody treatment from Regeneron. It is currently available to clinical trial participants or to those who have been granted an exemption for the use of compassion. In both situations, the drug is typically provided to the patient free of charge. However, this will most likely change when the treatment finishes studies and goes on the commercial market. These types of drugs are difficult to make, and other monoclonal antibodies cost thousands of dollars.
Health economists are just beginning to understand the full cost of coronavirus treatment as scientists figure out how the disease works and spreads. They have some early estimates: the average coronavirus hospitalization fee for a patient over 60, according to a damage database, FAIR Health, is $ 61,912
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This number includes any medical care provided during the hospital stay, such as a visit to the emergency room that led to admission or medication provided by the hospital.
For insured patients, this price is usually negotiated lower by their health insurance plan. FAIR Health estimates the median amount to be $ 31,575. This amount, like most things in American healthcare, varies significantly from patient to patient.
In FAIR Health's data on coronavirus patients over 60, a quarter billed less than $ 26,821 for their hospital stay. Another quarter costs more than $ 193,149, which is partly due to longer stays.
Many, but not all, health insurers have stated that they will not apply co-payments or deductibles to coronavirus hospital stays for patients, which could help protect patients from large bills.
However, uninsured patients could face full hospital costs and not receive discounts. While the Trump administration has set up a fund to cover the cost of coronavirus testing and treatment for uninsured people, The Times reported that some Americans without health insurance have received large bills for their hospital stays.
Probably the biggest billing risk for a patient receiving similar treatment to Mr. Trump would come from helicopter flights to the hospital.
Ambulances are expensive and often not part of the major health insurers' networks. According to a study in Health Affairs magazine published earlier this year, the average charge for an ambulance is $ 38,770. If the helicopter flight is outside the network – like about three quarters of them – Patients receive an average fee of $ 21,698 after their insurance is paid out.
Two helicopter flights, as Mr. Trump did, could plausibly result in more than $ 40,000 in medical debt for patients who do not have access to their own aircraft (although most people don't get out of the hospital by helicopter, of course).
The financial consequences of hospitalization with coronavirus could be long-lasting if a new Supreme Court challenge to the Affordable Care Act succeeds. In this case, it is argued that Obamacare is unconstitutional, including protecting the Health Act from pre-existing medical conditions. The administration filed a brief in June to support the challenge.
The Supreme Court hears this case on November 10th. If the challenge succeeds, Covid-19 could join a long list of pre-existing medical conditions that would result in patients facing higher premiums or denials of coverage. If so, coronavirus survivors could face a future where their hospital stays will add to their healthcare costs for years to come.