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August 2011 Moms
LJR 84
member
Was your lab work covered?
LJR 84
member
I'm just curious what the norm is. According to my insurance company's website, most of the tests are covered...but for some reason I always get charged for it at my doctor's office. I'm sure there's something I'm missing there, but I plan on calling my insurance company reglardless.
If your insurance does not cover your lab work, how much did it cost you? It's so strange because when I had my lab work done with DD last December, it was $270. This time they are telling me I owe $410. I thought that was bizarre considering we get a list of all the labs and the prices appear to all be the same. I'm definitely going to have to look into it.
In the long run it really doesn't matter too much. My deductable is $1000 so the sooner I meet it the less I'll be paying for my delivery...but still.
How's yours work?
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Re: Was your lab work covered?
I pay for everything out of pocket (drs visits, ect) until I hit the 3k ded and then I pay 20% until I hit my out of pocket max (another 3k).
This sounds like ours this time around. When I had DS, I was on my own insurance plan and it was awesome. I paid a total of $22 the entire time I was pregnant. Now that I'm a SAHM and on DH's insurance, we'll be paying closer to 5K.
Do you pay when you are at the doctors or do they send you a bill afterwards?
You should call your insurance company to see what your coverage is. If you have a $1000 deductible then there is a good chance that your labs and what not are only covered after you reach the deductible.
You should definitely question them on why the cost is going up to. That doesn't seem right.
I'm actually not sure about lab work... my mat coverage is 100%, with a $15 copay at any appt with an u/s and $250 copay at the hospital. I just got an agreement I have to sign for my OB's office when I went on Tuesday saying what I have to pay, so I'm going to have to call them back again.
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Well, I paid $200 yesterday, because that was closer to what I was expecting to pay. Looking back I wish I hadn't paid anything at all! I just contacted my insurance company and they said that yes, they do cover all lab work at 100%. So now I have to call the Dr's office and go through the mess of trying to talk to someone about it. A lot my my maternity stuff is covered at 100% (2 u/s's, etc) Last time I only paid for my lab work at the start and then delivery charges, which ended up being close to $3000.
It's so frustrating. I think the main problem is that a lot of times the people checking you out at the end are really not as informed as they should be, and don't know what they're doing.
That is ridiculous! My dr's office is also attached to the hospital, but they do the lab work in their office. I wonder if maybe this has something to do with it. If so, I'll b*itch them out.
That's just crazy.
We pay $500 out of pocket and then pay 80/20 until we reach our max out of pocket of $2500.
We have a payment plan with the OB to pay $1500 which includes all appointments and delivery. I've already had to pay full price for other Dr appointments but realize the sooner I meet my Max out of pocket the less DH and I have to pay out of pocket.
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It sounds to me like maybe your doctor's office did not send your blood to a PPO lab. I know with my insurance, my blood has to be processed by Quest to be covered. So either my doctor has to send to Quest or I have to go to a Quest lab to get my blood drawn. I would definitely follow up with the doctor and the insurance company.
My lab work is covered at 100% as best I can tell (and so long as processed by approved facility).
If you already paid then you should be able to submit a claim form to your insurance company to have them reimburse you for that and then going forward just tell your doctors office that your insurance company covers lab work and that they should send the bill directly to them.
A lot of times doctors offices want patients to pay up front and then make the patients deal with the insurance company to get reimbursed but it shouldn't work like that.