LAKELAND, Fla. (WFLA) — When Rebecca Harris’ husband tested positive for COVID-19 in early August and got worse at home, the couple decided to follow the advice of Gov. Ron DeSantis and get the monoclonal antibody treatment provided by the federal government.
They made an appointment to get the infusion at Lakeland Regional Hospital.
“It really did help, within a day or two he was back on his feet,” she said. “It was outpatient, he never got admitted. I think it took a little over an hour, the infusion itself and then I took him home.”
No doctor, no ER, but the hospital sent a statement including $842 for “emergency room” and $1,548 for “preventative care.” After insurance adjustments, they were charged $497 out-of-pocket.
Harris called and questioned the charges, starting with the one for the ER, and says she was told the nurse who gave the infusion normally works in the emergency room, and that is why they were charged for emergency room services.
In the fight against COVID-19, monoclonal antibody treatments have taken center stage. The federal government is covering the cost of the infusion treatment and patients typically pay nothing.
Providers can charge a fee to administer the treatment. These are typically covered by Medicare, Medicaid, and most private health insurances, although some plans may charge a copay.
When Harris couldn’t get answers, she turned to Better Call Behnken for help.
A hospital spokeswoman explained that the final bill that went to the insurance company only charged for the administration of the drug and not the ER claim. She explained that while state-run sites could give the drug out at no cost, hospitals and clinics are allowed by law to charge to provide the treatment.
The hospital sent this statement from Lance Green, CPA, Executive Vice President/Chief Financial Officer, Lakeland Regional Health:
“Insurance plans have been instructed by the federal government to cover medically necessary COVID-19 related treatment; however, there is no federal mandate requiring health insurance plans to waive patient cost-sharing obligations (i.e. annual deductibles, co-insurance, co-pays) for COVID-19 related care except for COVID-19 vaccinations. Lakeland Regional Health encourages individuals to discuss their patient responsibility for such treatment with their specific health plan to better understand their cost-sharing obligations under their own health plan benefits.”