The Denver Post

Health care: Test for virus will be free, but the visit may come with big bill.

But patients still can receive large bills, as one couple learned

- By Meg Wingerter Meg Wingerter: mwingerter@denverpost.com or @MegWingert­er

When a Denver woman spiked a high fever and felt extreme fatigue, she and her husband did what they figured was the right thing: They called their insurance company’s nurse line to find out if she needed to go to a hospital, chose one that was in network and went to find out if she needed to be tested for the new coronaviru­s.

Then the bill came: $4,449 for an emergency room visit and a lab test, which establishe­d her symptoms were coming from seasonal flu rather than COVID-19, the disease caused by the new virus that’s raising alarms globally.

The woman asked not to be identified because she was worried about repercussi­ons at work. Her husband, Kevin Gabelman, said they took the symptoms seriously because she works with children, meaning there were lots of opportunit­ies for her to be exposed to viruses, or to pass them on to others.

While they have insurance, they had to pay about $3,500 out of pocket to meet their deductible, even though she didn’t get any treatment besides advice to go home and rest, Gabelman said.

“That’s like 10% of her gross annual income for a two-hour visit,” he said.

With officials having announced the arrival of COVID-19 in the state Thursday afternoon, more and more Coloradans will be wondering who foots the bill if they begin showing symptoms of the disease caused by the coronaviru­s and need to be tested.

Colorado’s state lab does COVID-19 testing for free, and Vice President Mike Pence also announced the federal government would treat testing for the new virus as an “essential health benefit” that insurance must cover under the Affordable Care Act. Neither the state nor federal actions address other costs like copays to see a doctor, emergency room fees, or tests to rule out more common illnesses, like the flu.

New York Gov. Andrew Cuomo announced earlier this week that the state would require insurance companies waive some costs related to COVID-19 testing, including fees for seeking emergency room care. Gov. Jared Polis’ office didn’t immediatel­y respond to questions about whether Colorado would consider something similar.

The U.S. House of Representa­tives and Senate passed an $8.3 billion package to respond to COVID-19, which President Donald Trump is expected to sign. Most of the money would go to government­s at multiple levels to respond to the disease, and to develop a vaccine or treatment. Colorado is expected to receive about $9 million, but it’s not clear if it could use that money to reimburse patients or providers for the cost of care.

Nearly 500 experts in health care and academia signed a letter to federal officials this week raising concerns about potential hurdles to containing the new virus, including the cost of seeking health care.

“Control efforts will be less effective if some fail to seek appropriat­e diagnosis or care due to large out-of-pocket costs or copays,” the letter said.

About 6.5% of Colorado residents, or roughly 361,000 people, don’t have insurance, according to the Colorado Health Institute. About 20% of people polled in Colorado said they had skipped a doctor visit or not filled a prescripti­on because of cost, though, suggesting that even people with insurance sometimes struggle to pay for care.

Gabelman said he’s concerned that high out-of-pocket costs will discourage people from seeking care and allow illnesses to spread. He and his wife were able to cover their bill, but not everyone could, he said.

“It’s at minimum unfortunat­e, and, on the other side, it’s a little scary,” he said.

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