About a month ago, a picture from one of the Max Healthcare hospitals in NCR stirred up quite a storm on Twitter. The high cost of the ‘COVID-19 package’ charges didn’t sit well with the Twitterati. Although Max Healthcare clarified later that the package didn’t fully capture the inclusions, we did some digging to find out how much the treatment can actually cost.
COVID-19 treatment cost in private hospitals
Information on the precautions we need to take is abundant, the same on the cost of treatment isn’t. Some cases do not require you to be hospitalised, however, at-risk patients are admitted for COVID-19 treatment. ‘The Indian Express’ in May looked at patient bills in Delhi, Mumbai, and Kolkata, and found them to be between Rs 2.6 lakh to Rs 16 lakh, for a six-day to a month-long stay in top private hospitals.
The bills would cover your room rent, consultation, tests, PPE (personal protective equipment) for the doctors and medicines. ICU charges would be higher, especially if ventilators are required. Since the exact cure isn’t out there, experimental drugs/treatment can be used, which is bound to cost more. COVID-19 screening tests that were earlier being provided only by government hospitals have now become available in select labs; prices have now been capped. While in Delhi it is Rs 2,400, Maharashtra has capped it at Rs 2,800 for home collection and Rs 2,200 for samples deposited in hospitals. The price in Uttar Pradesh, Tamil Nadu and Karnataka is at Rs 2,500, Rs 3,000 and Rs 2,250. Often the test is not part of treatment packages.
‘The Times of India’ scrutinised the bill of a Chennai patient from a semi-private hospital. The 10-day hospitalisation totalled up Rs 1.8 lakh out of which Rs 1 lakh was the cost of just PPE kits for the staff and Rs 40,000 was the consultation fee.
In early June, the Association of Healthcare Providers had suggested fee caps for private hospital beds. Rs 15,000 per day for general wards, Rs 20,000 wards with oxygen facility, and isolation ICU beds at Rs 25,000 per day was suggested. Admission with ventilator in an ICU is as high as Rs 35,000 per day; use of high-end drugs would be exclusive of the price.With recent caps introduced in Delhi and Haryana, isolation beds are to be charged at Rs 8,000 per day. The fee for oxygen support is Rs 10,000 per bed. ICU beds would cost you between Rs 13,000 to Rs 18,000 depending on ventilator requirements.
While there have been recommendations from central agencies, and orders by local governments, there could be disagreements between hospital managements and the price. A risk of inflated prices, with support care looms.
Will health insurance cover costs?
We may assume that our health insurance is all-inclusive and would cover the COVID-19 treatment cost. That is untrue. While some insurers have started selling health plans that cover Coronavirus-related costs, your existing insurance may not be doing so.
There are few instances where insurers can reject health insurance claims:
- If you were admitted in order to undergo other treatment but also test positive for COVID-19, your claim may be treated as hospitalisation for other purposes. The virus-related may then not be covered.
- A room rent cap would mean your health plan would cover only a part of the rent. A Rs 5 lakh policy coverage would mean a rent cap of Rs 5,000 per day. This is at best 1/4th of the room rents in these situations.
- Another exclusion could be housekeeping chargers, if they are levied separately by hospitals. Other miscellaneous non-medical charges like admission fee, laundry, or even walking aids could be excluded from claims
- If you have a co-pay clause, you may be required to settle up as much as 30% of the bill upfront, before your insurer takes care of it.
Insurance claims ratio may move up, owing to an amendment made by the Insurance Regulatory and Development Authority. Patients can benefit from pharmacy, consumables, implants, and medical devices not being treated as ‘associate medical expenses’ by insurers. Nonetheless, costs per day remain high.
Costs could still remain high
Recently the Tamil Nadu government tried to cap non-insured per bed costs between Rs 5,000 to Rs 7,500 and an ICU bed at Rs 15,000. The costs for the insured patients was to be lower by about Rs 2,000 in all wards. But there has been resistance from hospitals who find this will ill-equip them to run the healthcare facilities.
Couple of days ago, the General Insurance Council released a schedule of rates for claims with its member companies. Per day fee for and ICU bed with ventilator has been capped at Rs 18,000 per day in the case of ‘very severe sickness’ in hospitals accredited with National Accreditation Board for Hospitals & Healthcare Providers.
If you are to require hospitalisation, you will have to shell out anywhere between Rs 1.5 lakh upwards for a 14-day stay. A month-long hospitalisation may require you to pay a minimum of Rs 5 lakh. ICU charges could be added up. We recommend connecting with your insurer to clarify on what they would cover, and if they cover COVID-19 treatment at all.
It is a bad year, without a doubt, and one can’t be better prepared. Saving and investing is a sound option, so is supplementing your health insurance and being aware of what is covered or not.