For Osmel Martinez Azcue, a recent trip to the hospital for coronavirus treatment resulted in good news and bad news: He didn’t have coronavirus, but he did have a $3,200 medical bill.
As first reported by The Miami Herald’s Ben Conarck, Azcue had checked himself into the hospital for flu-like symptoms after arriving back in the US from a work trip to China, concerned he had been exposed to the novel coronavirus.
He asked to be first tested for the flu before getting a CT scan to screen for coronavirus because of his limited insurance plan, Conarck wrote. He did have the flu, which meant he needed no further testing for coronavirus.
The whole experience cost $3,270, according to a notice from his insurance company he later received in the mail. Azcue told Business Insider his insurer had originally required him to provide three years of medical records proving the flu didn’t relate to a pre-existing condition. After The Miami Herald story was published, he said, the insurer called and emailed him, and clarified that the three-year requirement was an “administrative error.”
“We had concerns that your expectations of service were not being met based on some news articles that had come to our attention,” according to an email to Azcue from his insurer that was seen by Business Insider. Azcue’s insurer did not immediately respond to multiple requests for comment.
Medical documents verified by Business Insider show that Azcue’s deductible was applied after the administrative error was corrected, bringing his total co-pay down to $1,400. Here is the breakdown of procedures and costs.
Note that the procedures were identified based on American Medical Associations procedure codes and simplified in name.
Total charge: $56.75
Azcue’s co-pay: $13.45
CMP blood test
Total charge: $454
Azcue’s co-pay: $107.59
CBC blood test
Total charge: $209
Azcue’s co-pay: $49.53
Virus and flu testing
Total charge: $1,261
Azcue’s co-pay: $298.92
Infection testing, not specified
Total charge: $295
Azcue’s co-pay: $69.91
Total charge: $65
Azcue’s co-pay: $15.40
Infection testing, not specified
Total charge: $56
Azcue’s co-pay: $13.27
Total charge: $55
Azcue’s co-pay: $13.03
ER visit: Moderate severity
Total charge: $819
Azcue’s co-pay: $819
“It’s about the healthcare system”
While Azcue’s bill is one individual case, it does go to show how expensive a trip to the hospital can be if you have suspected coronavirus.
Luckily, the CDC — the only facility equipped to test for COVID-19 (the disease the virus causes) or designate other laboratories to do so — is not billing for testing. This means a patient who goes to the ER or urgent care for coronavirus treatment wouldn’t incur a charge for COVID-19 lab testing.
As Azcue’s case proves, though, patients aren’t off the hook for charges related to tests for other viruses or conditions, or the trip to the medical provider itself. How much a hospital stay would cost for a particular patient depends on what procedures are run and their insurance plan, if they have one. Azcue’s insurance plan, for example, didn’t cover the cost of an ER visit.
Azcue said he was aware of how his insurance plan worked, but the issue was that his insurer made things complicated when asking for three years of medical history. Even though this issue was rectified, he said he feared that other US residents would face similar complications.
While $1,400 is still a lot of money and he will struggle to pay it, he said he would still be able to from his $55,000 base salary. “I consider myself lower middle class,” he said. Also, he noted that he only graduated a year-and-a-half ago, has not had that kind of income for very long, and would likely not have been able to pay off the bill before then.
But Azcue said this story isn’t about him: “It’s about the healthcare system for the lower middle class of US citizens, especially in a national emergency situation.”