Costs for a Hospital Stay for COVID-19

April 23, 2020

According to public health experts, 15 to 20 percent of people who get COVID-19 and seek treatment may need a hospital stay for the disease. In a recent brief, FAIR Health studied what the costs of those hospital stays might be.

FAIR Health estimated the costs based on ICD-10 procedure codes and revenue codes associated with flu and pneumonia (lung inflammation caused by infection). We analyzed data from our database of over 30 billion private healthcare claim records, the largest such repository in the country. We found the average charge per COVID-19 patient requiring a hospital stay to be $73,300. That charge is the estimated cost for a patient with no health insurance. It’s also the cost for a patient seeing an out-of-network provider and whose health plan has no out-of-network benefit.

The average estimated in-network amount per privately insured patient is lower: $38,221. The in-network amount is the amount that the providers in the plan’s network have agreed to accept as full payment. It includes both the amount the plan pays and the amount the patient pays. The amount the patient pays is based on the cost-sharing provisions of the plan.

These numbers are useful to know to help you understand how much the COVID-19 pandemic is costing our country. But it’s also important to know that they’re not the actual amount you’re likely to have to pay if you or someone in your family gets COVID-19. If you have insurance, your costs will be determined by the cost-sharing terms of your health plan. If you don’t have insurance, your costs will vary based on your specific case. And you may be able to negotiate a lower amount with your providers.