Study: Complex COVID-19 Utah hospital stay averages $92k with insurance; $262k out-of-network

Dec 29, 2021, 7:19 PM | Updated: 9:40 pm

DRAPER, Utah – The final bill for a COVID-19 hospitalization can vary, depending on insurance, the severity of the case, and even what part of the country you live in, according to a recent study.

The analysis by FAIR Health looked at billions of private healthcare claims from the organization’s COVID-19 Cost Tracker online tool. 

“For complex and noncomplex hospitalizations for COVID-19 in 2020 and 2021, the West had the highest average allowed amounts and the South the lowest,” the study found.

Utah families who have experienced COVID-19 hospitalizations said the final bills can come with sticker shock.

“It’s a ton of work,” said Mindy Greene about managing the medical bills following her husband’s 94-day stay in the hospital battling COVID-19.

Mindy Greene said it took her four hours just to open and organize all the bills and that it was overwhelming when they first arrived.

“They were billing me like $400,000 and I was like, ‘Oh, my gosh. I don’t even know where to start with this,’” she said, adding that she took the advice to wait and deal with the bills once her husband arrived home.

Her husband, Russell, is returned home in September. Even months later, the family is still adding up the final cost.

“If I were to sit down with a calculator right now, I’m easily over a million at this point,” Mindy Greene said.

When it’s all said and done she thinks her family’s portion to pay will be around $50,000. She said she is choosing not to focus on the medical bills but instead on the blessings they’ve received.

“We’ll recover financially and we’ll end up being okay because my husband was able to come home because of the prayers and service that so many people offered,” she said.

The FAIR Health analysis was released on Dec. 15 and focuses on hospitalization bills from April 2020 to August 2021. The study shows the total charge amount, also called out-of-network, and the allowed amount, or in-network, that’s negotiated between the insurance plan and the hospital.

“For complex hospitalizations for COVID-19, the five states with the highest average allowed amounts were New Jersey, California, Alaska, Nevada and Arizona,” the study said. “New Jersey was highest, at $128,650.”

Nationwide, FAIR Health reports that a complex hospitalization averages $317,810 out-of-network or $98,139 with the allowed amount from in-network insurance.

Average hospital bills in Utah came in lower than those national totals. A complex hospitalization in Utah averaged $261,593 out-of-network or $92,307 with the allowed insurance amount.

For COVID-19 cases that required treatment but not hospitalizations, Utah was one of the five states with the lowest outpatient treatment costs with an average allowed amount of $732.

Nevada had the highest average outpatient treatment allowed amount at $1,538 while Maryland had the lowest at $580.

The founder of Utah COVID-19 Long Haulers Group said even outpatient treatments can add up with out-of-pocket costs.

“Probably last year, I spent just on copays probably close to $5,000. I went to the ER eight times,” said Lisa O’Brien.

O’Brien said a member of the group was hospitalized for a month and received a substantial bill.

“He received a bill in the mail that was in excess of a million dollars,” O’Brien said. “So imagine getting a bill like that in the mail. You’re trying to recover and it just adds to the stress.”

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Study: Complex COVID-19 Utah hospital stay averages $92k with insurance; $262k out-of-network