Materni21 billing warning

Leysin97 · June 2014

Ok so when I decided to get the materni21 test I was told the max I would have to pay out of pocket is $200. Well I just wanted to let you know that this is not entirely true. I took the test in April and just got the bill. If you have met your deductible then yes $200 co-insurance would be the max. If your insurance does not cover the test then yes they will reduce the price. I have heard to as low as $200 on this board.

Now for the warning part....IF you are lucky enough for your insurance to cover it your bill can be a lot higher as you will need to meet your deductible before coverage begins. So my bill is approx $700. about $670 going towards my deductible and then an additional $30 for co insurance. Normally I would not mind except that my deductible resets itself Sept 1st and I'm not due until October. Plus I do not think I would of reached my full deductible by then. I called and spoke to them about it (to see if it could be reduced) and they said since my insurance covers it and this is my deductible cost there was nothing they could do. They could only reduce it if it was not covered.

I am not upset since there is really nothing I can do about it now (even though I had a lengthy discussion with my insurance company and Dr. office before hand). Plus I have the results and peace of mind. I just wanted to give all of you the heads up if this is something you are thinking about.

MallardDucky · June 2014

I don't get this. You still have to pay the deductible anyway so regardless of any testing that money still stands till you meet it.

enigmasara · June 2014

My MaterniT21 test applied to my out of network deductible & my insurance allowable for the test was right around $750. Even though it was covered, I called Sequenom (the lab that runs the test) and they adjusted my patient responsibility from that $750ish to $200. It's weird that they gave you a different response than they gave me.

Leysin97 · June 2014

@MallardDucky‌ yes I get that but if my insurance didn't cover it I would only have to pay $200 right now. By Sept 1 I would not use the rest of my deductible so would never potentially have to pay that. My deductible resets itself Sept. 1.

@enigmasara‌ yeah that's strange. I read that somewhere else on the board too. I guess I will try and call again Monday.

Leysin97 · June 2014

@enigmasara‌ Was that $750 supposed to be towards your deductible? Or was that your co- insurance?

enigmasara · June 2014

Leysin97 said:

@enigmasara‌ Was that $750 supposed to be towards your deductible? Or was that your co- insurance?

It all applied to my out of network deductible.

katiefritzler · June 2014

All I have to say is I'm glad I live in Canada, where things like eye appointments aren't free, but would fall under almost any insurance policy, and any kind of testing is free, as well as doctor appointments and the such.

jaminjeff · June 2014

I'm nervous about this right now. I was told the most I'd pay out of pocket was $185 and it just showed up on my insurance billing site this week. They marked that they're paying $0 of it, which is never good. The charge is for $3,447.

MrsDL · June 2014

I'm waiting to see what happens with mine - I called my insurance company (Cigna) to specifically make sure this was covered - I was told yes. I'm on a complete in-network plan, so nothing out of network is covered, but Cigna has a huge network. Well the test was covered by the brand name (they told me this and it's in writing). What I didn't think to ask is whether Sequenom is in-network - it's not. So it was initially denied (Sequenom is working with Cigna on my behalf which is nice). How ridiculous is that - the test is approved but the only lab that offers it is not in network so technically it's not covered. Cigna said it would probably be approved with an appeal, otherwise I'll have to deal with Sequenom but what a headache.

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