Anyone have Humana insurance AND get a bill for your chromosomal testing??

Re: Anyone have Humana insurance AND get a bill for your chromosomal testing??

• GingerDS02 member

  October 2014

  SharkFarts said:

  So it sounds like they told you it wasn't fully covered because it was out of network, but you're upset because you still had it done and it's not fully covered?

  
  

  I had heard the test was very expensive, but I don't know how much it costs, so I don't know if the $600 is the full cost or just what you're responsible for. At least it will go towards your deducible?

  
  

  No, they didn't tell me in advance that it would be out of network (and I did ask SPECIFICALLY about the MaterniT21 by brand name via their secure email).  There was no mention that it would be out of network.  They stated that it would be covered at 90% if I met the "high risk" qualifications which I did.  I called the lab to find out what my portion of that fee would be.  I had already fully met my deductible for the year.   Insurance paid 70% and I was left with 30% rather than 10% because the lab is "out of network".  The in network labs are all Quest/Labcorp type labs, not capable of that type of testing.

  

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• GingerDS02 member

  October 2014

  I just wanted to come back and update this thread in case anyone searches for something similar.  I called Sequenom and told them that Humana had originally said they'd pay 90% and only paid 70% because it turns out Sequenom is "out of network".  Anyway, the rep reduced the fee to $200 and said that's the contractual patient portion (or something along those lines) with Humana since they are considered "out of network".  Not sure if that's applicable for other insurance companies but wanted to update in case others recieve a larger than expected bill.

  

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• dana1047 member

  October 2014

  I have BCBS, called to verify it was covered prior to the test (it was due to my age), but still got a bill for $1500 ugh. Now I had to file for a review.

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• pnutg member

  October 2014

  dana1047 said:

  I have BCBS, called to verify it was covered prior to the test (it was due to my age), but still got a bill for $1500 ugh. Now I had to file for a review.

  Yikes.
  

  

  
  

  
  

  
  

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• GingerDS02 member

  October 2014

  @dana1047, was it the MaterniT21?  If so, have you tried calling Sequenom?

  
  

  

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• Sharon&Paul member

  October 2014

  This is discussed a lot on the pregnant over 35 group. You should be able to find some answers. Basically the company will only ever charge the patient $200, but you need to call them. Also several people have posted getting a bill, but once they files the appeal it was taken care of. I would not pay anything until you appeal it, since it seems like in every case the cost goes down.
  

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• dana1047 member

  November 2014

  GingerDS02 said:

  @dana1047, was it the MaterniT21?  If so, have you tried calling Sequenom?

  
  

  It was actually Verify
  
  

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• Annoid619 member

  November 2014

  Same here but not as high of a bill, only $100. I did Verifi and was told it was 100% covered and in-network. I called my insurance company who confirmed it was 100% covered and then called the lab. They reversed the charges completely. I have Cigna. I think it's the labs trying to get any $ they can. I almost paid the $100 because I didn't want to deal with it. Glad I didn't, that'll buy us some diapers.

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