- Brooklyn public-school teacher Erin McCarthy went to the NYU Langone Health emergency department in Cobble Hill, Brooklyn, after experiencing symptoms associated with the coronavirus.
- A physician at the ER told her she didn’t meet the criteria to be tested for the coronavirus and sent her home.
- She later discovered NYU Langone charged her over $US10,000 for her visit, even though she didn’t receive a test for the coronavirus.
- Thanks to her health insurance, she will have to pay only $US75 out of pocket – but the visit raises questions of how those without insurance will be able to afford tests and care for COVID-19.
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When she was suffering from a fever, headaches, and tightness in her chest, Brooklyn public-school teacher Erin McCarthy went to a local emergency room to get tested for the coronavirus.
After a nearly six-hour visit, she said she left without getting tested for the coronavirus and was later slapped with an astonishing medical bill of $US10,382.96.
While she will pay only $US75 out of pocket, and her insurance company will pay a negotiated-down rate, she said her experience laid bare some very real concerns as the novel coronavirus spreads across the US: the cost of COVID-19 testing and care.
While her insurance coverage saved her thousands of dollars this time, McCarthy was previously hurt in a fall while she was uninsured – it took her years to pay off the ambulance bill.
“But imagine if I didn’t have insurance,” McCarthy told The City.
Doctors said McCarthy was not eligible for the coronavirus test
On March 2, McCarthy, 44, said she took herself to the NYU Langone emergency department in Cobble Hill, Brooklyn, after experiencing symptoms associated with COVID-19, the disease caused by the coronavirus. She had recently travelled to a region of Italy hard hit by the novel virus. The government is now fighting to control the spread of the virus in the country where infections have soared past 10,000.
The veteran teacher, who hoped to get tested for the virus, said she spent six hours in the emergency room – 20 minutes with a doctor, a short amount of time getting a chest X-ray, and the majority of the visit spent waiting.
“And I wasn’t even tested,” McCarthy told The City.
After hours of waiting around for a test, a doctor in a hazmat suit told her she would not be eligible for the test, despite her showing COVID-19 symptoms, because she did not have immune-system issues and is not elderly.
A patient displaying coronavirus symptoms should fit certain criteria provided by the Centres for Disease Control and Prevention to receive a test for COVID-19, since the testing capacity for the virus remains limited. This includes people who have a history of travel to an area with ongoing transmission of the disease, including China, Iran, Japan, and South Korea. Travel to Italy was not included in the affected areas that prompt a coronavirus test at the time of McCarthy’s visit – but it is now.
A spokesperson for NYU Langone told Business Insider that billing for hospital services is different for each patient, provider, and insurer. The final bill is also affected by what the patient was seen for and what services were provided by the hospital.
“In addition, there are different parts to a patient bill. One part is what the hospital charges the insurance company; one part is what the insurance company negotiates with the provider and eventually pays; the last part is what the patient owes for the services (also called the co-pay),” the spokesperson added.
The spokesperson said “the bill in question charged the insurer a fee, the insurer paid a negotiated percentage of that fee and the patient owed only a co-pay of $US75.00.” However, it remains unclear why the NYU Langone emergency department in Cobble Hill initially billed her and her insurance company over $US10,000.
Business Insider asked NYU Langone to clarify whether the high costs for her care were related to the services she received or specific to treating a patient who believes they have the coronavirus. The hospital declined to answer but said HIPAA “regulations restrict us from speaking to other issues related to her case.”
McCarthy was later tested for COVID-19 after the New York City health commissioner expanded testing for educators, emergency responders, and health workers. While she discovered that she had not contracted the disease, she believes her visit raises questions about the access and affordability of care for those without health insurance.
The accessibility of coronavirus care
So far, the US has 31 reported coronavirus deaths and more than 1,150 cases. As the novel virus sweeps the country, Americans have raised concerns about the costs of testing and care related to COVID-19, which many believe could discourage people from seeking care.
On Tuesday, New York Gov. Andrew Cuomo announced a directive ordering health insurers to waive all costs related to the coronavirus for emergency-room, urgent-care, and doctor visits.
“We can’t let cost be a barrier to access to COVID-19 testing for any New Yorker,” Cuomo tweeted.
Vice President Mike Pence, who has been charged with tackling the spread of the virus in the US, announced on March 10 that major insurance companies, including Anthem, Cigna, Humana, and Aetna, would waive copays for testing and cover the cost of treatment of COVID-19 for Americans nationwide.
However, those without health insurance and Americans on Medicare and Medicaid may be forced to pay up. The Trump administration said Medicare and Medicaid might not cover all care related to the coronavirus.
Seema Verma, the administrator of the Centres for Medicare and Medicaid Services, said on Monday evening that her agency may not be able to pay for all “products and services” required for coronavirus patients dependent on government insurance.
“We are looking at what we cover and clarifying the types of products and services that our programs will be able to pay for in terms of Medicare and Medicaid,” Verma said.