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Post by lisae on Feb 28, 2023 22:38:58 GMT
Last year and this year I've had to have my doctor's office refile paperwork to get my cholesterol screening covered. I had my physical nearly 6 months ago and I just now have a new End of Billing statement that shows they are approving my getting the screening but pay nothing. They reduced the amount I could be charged. They do pay the doctor's bill in full.
That last part happens every year and I pay a few dollars not only for cholesterol but some of the other basic blood work as well. Usually the total is $15, this year it is $22. This year I will pay over $11,000 in health care premiums. A physical and mammogram are the only things covered without going against my $7000 deductible. The bloodwork isn't much but it irks me that it isn't covered.
Does anyone have a policy without copays and has to pay for routine blood screenings?
ETA: The reason I think it should be covered is because the ACA mandates some preventative services like an annual wellness check be covered. How do you do a proper check without basic bloodwork?
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Post by katlady on Feb 28, 2023 22:42:14 GMT
No, bloodwork is all covered, along with my annual exam. The doctor authorizes the blood work, I don’t know if that makes a difference. I have no co-pay for any of my annuals. I haven’t had my annual yet in 2023, so I am expecting the same.
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Post by Merge on Feb 28, 2023 22:43:11 GMT
I pay a $2500 deductible and lab fees are subject to that, so yes, I typically pay for them in their entirety. I ask my doctor not to request any labs that aren’t strictly necessary. My last physical, the blood work and other tests cost me about $250.
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pilcas
Pearl Clutcher
Posts: 3,148
Aug 14, 2015 21:47:17 GMT
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Post by pilcas on Feb 28, 2023 23:08:01 GMT
I pay a $20 dollar copayment for bloodwork. Doesn’t have to be approved though.
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Post by **GypsyGirl** on Feb 28, 2023 23:09:42 GMT
We have a $3,000 deductible each and pay 100% of everything until we reach that deductible. That includes labwork and blood tests. Once that threshold is reached, we pay nothing out of pocket unless it is out of network.
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Post by lisae on Feb 28, 2023 23:19:03 GMT
We have a $3,000 deductible each and pay 100% of everything until we reach that deductible. That includes labwork and blood tests. Once that threshold is reached, we pay nothing out of pocket unless it is out of network. Do you not at least get your physical covered? The ACA mandates that some preventative care must be covered.
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Post by busy on Feb 28, 2023 23:20:29 GMT
Covered in full for us. But we're ridiculously lucky with our coverage - no premiums, no deductible, no co-insurance. I'm very grateful (but think it's pathetic that coverage like mine is so rare).
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Post by summer on Feb 28, 2023 23:28:50 GMT
I get extensive blood work every 3 months. My insurance covers it. I don’t have a deductible. I need to go to the correct lab though, the one inside my doctors office was in my plan for years. They switched labs there and I didn’t realize and was billed for over a thousand dollars. I didn’t end up having to pay it but now I make sure I’m going to a lab that is covered by my insurance.
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Post by Scrapper100 on Feb 28, 2023 23:34:47 GMT
I haven’t had to pay for bloodwork that I ever remember. I think I have had to pay for xRays on occasion.
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Post by huskermom98 on Mar 1, 2023 0:26:49 GMT
I had lab work done the last time I had my annual physical and then a few months later to checkup on issues, but I don't remember what if anything I had to pay for it. DS had to have labs drawn for the first 3-4 months after he started Accutane last fall and we had to pay $5ish each time (but the bill came months later).
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Post by freecharlie on Mar 1, 2023 0:31:32 GMT
Always had to pay for blood work unless I've hit my deductible
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iluvpink
Pearl Clutcher
Posts: 4,370
Location: Michigan
Jul 13, 2014 12:40:31 GMT
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Post by iluvpink on Mar 1, 2023 1:17:56 GMT
I have never once had to pay for any kind of blood work for any of us. And gosh knows dd has had a ton of it. It's all covered under our insurance.
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Post by Linda on Mar 1, 2023 1:20:45 GMT
I have quarterly bloodwork and yes, I pay the deductible and then the co-insurance until we meet our max out of pocket.
I know the insurance covers my annual physical (including chest x-ray and ecg) and well-woman exam 100% - I'm honestly not sure if they cover some of the lab work once a year or not - I think all of mine is related to my diagnoses so probably not. There's also no deductible on my prescriptions - just the co-pay (most of mine are actually covered 100% as maintenance drugs on the formulary but I'm on one expensive one and only pay $50/90 days)
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Post by SallyPA on Mar 1, 2023 1:25:01 GMT
No. It goes towards my deductible. Insurance sure ain’t what it used to be. I choose to do the cheaper health fair bundled labs that I pay up front for instead of billing insurance. It’s still cheaper since I usually don’t meet my deductible.
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christinec68
Drama Llama
Posts: 5,388
Location: New York, NY
Jun 26, 2014 18:02:19 GMT
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Post by christinec68 on Mar 1, 2023 1:25:48 GMT
I have to make the 25 co pay for blood work at an approved lab.
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Post by peasapie on Mar 1, 2023 1:30:12 GMT
I had medical insurance through NY State of Health, paid $12,000 per year but blood work was covered, as well other tests and yearly checkup and after that, deductible up to 1,000. Now I’m 65 and on Medicare, much better. That must be very difficult for you to pay all the blood tests.
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Post by lisae on Mar 1, 2023 2:16:40 GMT
That must be very difficult for you to pay all the blood tests. It's really not that much money because the insurer has a cap on what they will allow to be charged. It's just the idea that they have to pay for my physical but they don't cover the bloodwork you need to really have a good physical exam. I can see from the responses that many others are paying for the bloodwork that goes along with a physical.
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Post by revirdsuba99 on Mar 1, 2023 5:51:21 GMT
I don't pay for blood work, but my thyroid has to be checked regularly, maybe that is why? LabCorp once tried to charge me for Vitamin D testing, but they did the draw for full labs and nothing more was said.
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Post by pajamamama on Mar 1, 2023 6:39:25 GMT
Yes. it's $30 every time I get bloodwork done and it angers me no end. If I lived in a city I could go to several labs that would be covered, but I live rurally with a serious diagnosis of ALL (leukemia). Not doing it is not an option so I had to come to terms with the fact that I simply could not, and will not pay for it. We would be homeless. They will not waive it. It sucks and is WRONG.
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Post by peasapie on Mar 1, 2023 11:33:47 GMT
Yes. it's $30 every time I get bloodwork done and it angers me no end. If I lived in a city I could go to several labs that would be covered, but I live rurally with a serious diagnosis of ALL (leukemia). Not doing it is not an option so I had to come to terms with the fact that I simply could not, and will not pay for it. We would be homeless. They will not waive it. It sucks and is WRONG. It sounds like you should be eligible for Medicaid. Have you looked into that?
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Post by lisae on Mar 1, 2023 12:13:16 GMT
Yes. it's $30 every time I get bloodwork done and it angers me no end. If I lived in a city I could go to several labs that would be covered, but I live rurally with a serious diagnosis of ALL (leukemia). Not doing it is not an option so I had to come to terms with the fact that I simply could not, and will not pay for it. We would be homeless. They will not waive it. It sucks and is WRONG. I'm sorry that is wrong. You should have the same financial outcome as someone in a city.
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Post by revirdsuba99 on Mar 1, 2023 12:13:53 GMT
Yes. it's $30 every time I get bloodwork done and it angers me no end. If I lived in a city I could go to several labs that would be covered, but I live rurally with a serious diagnosis of ALL (leukemia). Not doing it is not an option so I had to come to terms with the fact that I simply could not, and will not pay for it. We would be homeless. They will not waive it. It sucks and is WRONG. I agree with peasapie check about Medicaid!!
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smartypants71
Drama Llama
Posts: 5,818
Location: Houston, TX
Jun 25, 2014 22:47:49 GMT
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Post by smartypants71 on Mar 1, 2023 12:58:56 GMT
No - as part of my benefits, we get what's called an executive physical. All bloodwork, EKGs, hearing tests, mammo, etc are covered. However, if a different doctor were to order bloodwork, then the labs would be subject to my copay (10% after the $1500 ded).
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Post by workingclassdog on Mar 1, 2023 13:40:35 GMT
Mine is covered. I haven't paid for bloodwork in a long time.. I really can't remember if I have ever paid for it.
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Post by bratkar on Mar 1, 2023 13:56:16 GMT
As long as my routine blood work is coded as such, mine are covered once a year. If they submit a diagnosis of anything other then well visit it will apply to my deductible and copay. There is about 5 lab tests that are covered as preventative
End of billing ? ( do you mean Explanation of benefits statement from they insurance company?)
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Post by cindyupnorth on Mar 1, 2023 14:50:16 GMT
Mine does not cover the annual bloodwork. IF they submit it to my insurance, the price for it is ridiculous. And then insurance denies it. SOo, what I have to do every yr, is go thru what my dr wants me to have. I usually know. CBC, cholesterol, and BMP. The dr does NOT order the bloodwork, otherwise insurance will get involved. I then go in, and pay cash. They have an ala cart, direct pay listing. And I usually pay 50$ for all my labs with cash. it's so dumb. And my insurance is thru my work, which is a health care Co. But that is something to look in to and ask about. Direct pay, ala'cart
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AmandaA
Pearl Clutcher
Posts: 3,502
Aug 28, 2015 22:31:17 GMT
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Post by AmandaA on Mar 1, 2023 17:34:56 GMT
We have a $3,000 deductible each and pay 100% of everything until we reach that deductible. That includes labwork and blood tests. Once that threshold is reached, we pay nothing out of pocket unless it is out of network. Do you not at least get your physical covered? The ACA mandates that some preventative care must be covered. The catch might be if they are coding it correctly. My DH’s old MD would never code the physical or labs as preventative care and always submitted them with just codes for hypertension 🤬 so they got denied every time and went against our 🤑 deductible.
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Post by mayceesgranny on Mar 1, 2023 20:11:56 GMT
With my high deductible health plan I am allowed an annual exam and corresponding labs once each year ( as part of ACA). If there are blood tests that are outside of those considered as preventable annual labs I pay for those until I hit my deductible. So if in quarterly for an A1c test I pay for that.
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Rhondito
Pearl Clutcher
MississipPea
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Member is Online
Jun 25, 2014 19:33:19 GMT
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Post by Rhondito on Mar 1, 2023 20:13:06 GMT
Most of my labwork is covered but I have to pay for my cholesterol screening. I think it ends up being $19. I think it's ridiculous.
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Post by lily on Mar 1, 2023 20:18:10 GMT
Mine used to but the last 2 years I have had to pay some for the bloodwork and yes it irks me too!! It is PREVENTATIVE CARE.
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