Treatment for out-of-network, complex COVID costs over $355K in Florida


Emily Boerger


Data out of FAIR Health shows Florida with some of the highest costs for complex COVID-19 treatment and hospitalizations in the country. The data, which was released as part of FAIR Health’s “States by the Numbers” series, evaluates both out-of-network and in-network charges for inpatient and outpatient COVID care.

Using its repository of over 35 billion private health care claims, FAIR Health launched a series of interactive maps this week to illustrate how COVID treatment charges vary throughout the United States.


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For complex COVID-19 inpatient care, which includes patients admitted to the hospital who require ventilation or admission to the ICU, the average out-of-network charge amount in Florida is $355,450. On this measure, just 7 states rank above Florida.

For in-network charges for complex inpatient treatment, the average allowed value in Florida is $99,301.

Florida ranks in the mid-range of states for its costs for noncomplex inpatient care, which is defined as patients who are admitted to the hospital but do not require ICU admission or ventilation. Costs might be related to lab testing, imaging, room and board, and IV therapies.

For this type of care, the average out-of-network charge in Florida is $67,620. The in-network charge value is $24,752.


Image: FAIR Health


For outpatient COVID treatment, which may include costs related to physician or urgent care visits, Florida’s average out-of-network charge is $3,172. Just three states – California, Nevada, and Alaska – have higher costs on this measure. The average in-network outpatient treatment in Florida is $1,169.

An August report from the Peterson Center on Healthcare and the Kaiser Family Foundation finds close to 75% of the nation’s largest health plans are no longer waiving cost-sharing for COVID treatment.

“Almost half these plans (50 plans) ended cost-sharing waivers by April 2021, which is around the time most states were opening vaccinations to all adults. Of the 29 plans still waiving cost-sharing for COVID-19 treatment, 10 waivers are set to expire by the end of October.”

Early on in the pandemic, reads the report, about 88% of people in enrolled in fully-insured private health plans would have had their out-of-pocket costs waived if they had been hospitalized with COVID.