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Post by iamkristinl16 on Sept 17, 2024 21:45:52 GMT
I saw a provider regarding perimenopause and possible HRT or other treatments to help with some symptoms I have been having. She recommended bloodwork to test my hormones, vitamin D, etc but said she really had no idea about the cost and said "it could be $700, could be $1400, I am not really sure." I was prepared to get the bloodwork done when I got there but after she said that I am a little unsure. If you have had this done, do you know the cost? Particularly if your deductible isn't met?
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Post by christine58 on Sept 17, 2024 21:49:04 GMT
$30 co pay. Check with your insurance
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pantsonfire
Drama Llama
Take a step back, evaluate what is important, and enjoy your life with those who you love.
Posts: 6,273
Jun 19, 2022 16:48:04 GMT
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Post by pantsonfire on Sept 17, 2024 22:04:45 GMT
Call the pharmacy and your insurance. Each lab will have its own fees.
All labs are $0 for us. Some require orionauth (like genetic tests as those cost $5000-15,000)
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Gem Girl
Pearl Clutcher
......
Posts: 2,686
Jun 29, 2014 19:29:52 GMT
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Post by Gem Girl on Sept 17, 2024 22:18:33 GMT
You can even do it at home. Google "home hormone level test."
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Post by JustCallMeMommy on Sept 17, 2024 22:18:55 GMT
My doctor charges $40, and its done once a year. He doesn't take insurance, so that's the whole thing. He does a hormone, thyroid, etc.
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Post by Basket1lady on Sept 17, 2024 23:16:21 GMT
Is it part of your deductible? For us (Tricare), all lab work is free and not part of our co-pays.
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Post by Zee on Sept 18, 2024 2:06:34 GMT
No one can really tell you, it depends on if your insurance covers it or not and what the lab will charge you. It SHOULD be covered if menopause and HRT are in the works and the right codes are used, but I don't know for sure what your plan covers or excludes.
If they cover it but you still need to meet your deductible, the lab is only allowed to charge you whatever your insurance company contracted amount is.
Or, you might have a lab copay. You'll need to check with your insurance to see what is covered and the allowed amount paid by your insurance. If they don't cover it at all (which would be highly unusual), then you will need to check with the lab to see what the cost is.
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Post by iamkristinl16 on Sept 18, 2024 3:44:33 GMT
No one can really tell you, it depends on if your insurance covers it or not and what the lab will charge you. It SHOULD be covered if menopause and HRT are in the works and the right codes are used, but I don't know for sure what your plan covers or excludes. If they cover it but you still need to meet your deductible, the lab is only allowed to charge you whatever your insurance company contracted amount is. Or, you might have a lab copay. You'll need to check with your insurance to see what is covered and the allowed amount paid by your insurance. If they don't cover it at all (which would be highly unusual), then you will need to check with the lab to see what the cost is. How do I find out what is covered if I don’t know the billing codes? I wish there was an easier way of knowing what you will be charged for medical tests and procedures before you do them rather than being surprised later.
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snyder
Pearl Clutcher
Posts: 4,343
Location: Colorado
Apr 26, 2017 6:14:47 GMT
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Post by snyder on Sept 18, 2024 3:57:10 GMT
No one can really tell you, it depends on if your insurance covers it or not and what the lab will charge you. It SHOULD be covered if menopause and HRT are in the works and the right codes are used, but I don't know for sure what your plan covers or excludes. If they cover it but you still need to meet your deductible, the lab is only allowed to charge you whatever your insurance company contracted amount is. Or, you might have a lab copay. You'll need to check with your insurance to see what is covered and the allowed amount paid by your insurance. If they don't cover it at all (which would be highly unusual), then you will need to check with the lab to see what the cost is. How do I find out what is covered if I don’t know the billing codes? I wish there was an easier way of knowing what you will be charged for medical tests and procedures before you do them rather than being surprised later. Both my patient portal and my medical insurance account have estimates for costs. I've only used it a couple of times, because now, it autmatticall does it. For example, i have a face to face appointment with my doctor next week. When I login, it shows that appointment and tells me that there is no cost to me as I do not have copays for office visits. But, before that, they had a tab and you would do a search for the name of the labwork like complete RBC, Tsh etc.
Also, as others have mentioned, it really depends on your insurance and there are sooooooo many variables to all the different insurance plans out there, but in many plans that I am aware of, its not straight deductible first. Some say 20-30% coinsurance, which meants that if your labs were $1,000, you would pay $200-300, they pay the rest, but the $200-300 would count towards your deductible. Do you have an insurance website account? You should be able to logon to that and look up your plan and see how items are covered. Health insurance sucks. Good Luck!
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Post by Zee on Sept 18, 2024 4:12:22 GMT
No one can really tell you, it depends on if your insurance covers it or not and what the lab will charge you. It SHOULD be covered if menopause and HRT are in the works and the right codes are used, but I don't know for sure what your plan covers or excludes. If they cover it but you still need to meet your deductible, the lab is only allowed to charge you whatever your insurance company contracted amount is. Or, you might have a lab copay. You'll need to check with your insurance to see what is covered and the allowed amount paid by your insurance. If they don't cover it at all (which would be highly unusual), then you will need to check with the lab to see what the cost is. How do I find out what is covered if I don’t know the billing codes? I wish there was an easier way of knowing what you will be charged for medical tests and procedures before you do them rather than being surprised later. You don't need the billing codes to get an estimate of the lab costs or what insurance covers. If you know the names of the labs, they can look it up. Or you can just find out if they will pay for hormone levels needed for HRT and go from there. The vitamin D test should be covered. Like I said, it should all be covered, but all plans are not equal.
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peppermintpatty
Pearl Clutcher
Refupea #1345
Posts: 3,990
Jun 26, 2014 17:47:08 GMT
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Post by peppermintpatty on Sept 18, 2024 13:48:03 GMT
Vitamin D usually isn't covered unless another blood test is done with it. It is considered a "luxury" which makes zero sense to me. My ds needed it done and insurance came back with saying that it wasn't covered but since LabCorp didn't have me sign something saying that I knew it wasn't covered, I didn't have to pay the $300 for that test. So I can only speak for that one.
LabCorp will always give you your estimated cost before they do the tests.
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Post by Merge on Sept 18, 2024 13:55:19 GMT
People in other countries shaking their heads at us right now.
I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do).
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Post by Zee on Sept 18, 2024 16:43:36 GMT
People in other countries shaking their heads at us right now. I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do). They might, but most office staff does not have the time to check with every single insurance provider for every patient to figure out what might or might not be covered. That's really on the patient, unfortunately. It USED to work that if the doctor felt you needed it, it was covered. Those days are long gone and insurance covers less and less.
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Post by cindyupnorth on Sept 18, 2024 17:35:44 GMT
I pay for all my lab work direct care. You don't need a Dr's orders, you just need the name of the tests. Your lab should have a list of the tests they offer and the costs. My insurance does not cover much for lab, and the lab costs thru insurance are much more. So a 400$ lab test billed thru my insurance, and they pay 20$ of it. I pay for direct pay of 30$. Yea, it's messed up.
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Post by Merge on Sept 18, 2024 19:21:15 GMT
People in other countries shaking their heads at us right now. I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do). They might, but most office staff does not have the time to check with every single insurance provider for every patient to figure out what might or might not be covered. That's really on the patient, unfortunately. It USED to work that if the doctor felt you needed it, it was covered. Those days are long gone and insurance covers less and less. It's true that not everything is covered any longer, but my experience has been that providers affiliated with larger hospital systems at least can generally put what is being prescribed into the computer database and find out what it will cost the patient through their insurance. More and more, of course, providers here are leaving those large hospital systems and going concierge or setting up a private practice that simply doesn't take insurance.
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Post by Delta Dawn on Sept 19, 2024 0:51:39 GMT
People in other countries shaking their heads at us right now. I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do). I know I am. You have the best technology in the world and the OP is wondering how to live the rest of her life. Good god.
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Post by jenb72 on Sept 19, 2024 17:56:27 GMT
I first did hormone testing with a local health clinic (a test involving labs/bloodwork) and that one was $50 (not covered).
I then found a gynecologist who would test them for me. Her test (a spit test that had to be done on a specific day in my cycle that she felt was more reliable for women) was not covered by my insurance either, so I had to pay out of pocket and it was $130.
I went with the results from my Gyn's test and she prescribed me a HRT compound cream that I use once daily on days 1-25 of my cycle. Each refill lasts me about 2 months and costs me $55.
Because her test isn't covered and is more expensive, after the initial test she doesn't test again unless she thinks it's absolutely necessary (or if I request it myself). Instead she adjusts my prescription based on how my symptoms are being managed. So far most of them are being managed pretty well. We've had to make a couple of adjustments over the course of this last year, but nothing major.
Jen
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Post by cakediva on Sept 19, 2024 20:28:57 GMT
People in other countries shaking their heads at us right now. I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do). Raising my hand Canadian - so if bloodwork is wanted by my family doctor, it's covered. Although we did pay $100 out of pocket for DD's gluten testing a few years ago. But bloodwork ordered by my Naturopath is not covered. So she sent me to my doctor to get things ordered - it wasn't out of the blue, I'm in peri-menopause so it was time to go and say "hey it's time to..." and then once I had the request form, she looked it over and added to it (separate form). I only had to pay out of pocket for the tests the Naturopath added. And then DH's benefits covered that under my Naturopath coverage so win win!
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Post by Merge on Sept 20, 2024 0:13:58 GMT
People in other countries shaking their heads at us right now. I'd call the insurance company and ask what info they need from the doc to give you a quote. Alternatively, your doctor's office may be willing to coordinate with insurance to give you a quote (that's what they should do). Raising my hand Canadian - so if bloodwork is wanted by my family doctor, it's covered. Although we did pay $100 out of pocket for DD's gluten testing a few years ago. But bloodwork ordered by my Naturopath is not covered. So she sent me to my doctor to get things ordered - it wasn't out of the blue, I'm in peri-menopause so it was time to go and say "hey it's time to..." and then once I had the request form, she looked it over and added to it (separate form). I only had to pay out of pocket for the tests the Naturopath added. And then DH's benefits covered that under my Naturopath coverage so win win! I have an appointment with a peri/menopause specialist next month and I'm scared to find out how little will be covered by insurance. 'Murica!
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