Lab costs

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I just received the explanation of benefits from my insurance company for a blood test that was done on my first visit to the specialist 4 months ago. They told me they had to do it at the McBride Clinic because I am in a rural area and they don't have the equipment to "drill down" to the details so they do them there. I have not received a bill from McBride yet. The EOB showed where they billed the Lab involved for almost $1,000 !! Now I received another EOB for another out of network provider for the same lab work for almost another $1,000 which I am responsible for! Then a letter from the insurance company saying they are requesting more information from the clinic for a charge of $87. WOW. Why would a blood test cost  $2,000? His office call is $650! I am thinking since I have mild RA I could get a regular doctor to take care of me. I am having to travel 150 miles to this doctor and just had a flare. I called and you have to leave a message and pray they call you back. They called back with a mextro pack and no pain pills. This in itself is very stressful for me but the nearest specialist are 150 any way you look at it. I have an appt in June and hope they don't "present" me with an outrageous bill. I was told an internal specialist can handle RA. and I'm thinking of just getting a regular doctor to handle this.

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  • Posted

    It's probably not of much comfort, but my friend with cancer applying to a famous alternative clinic in Houston, Texas (forgotten its name) was told that the blood test she needed to have to find out whether she would qualify for the clinic's in-patient course of treatment would cost her $6000.!

    Yes, six thousand for a blood test that would determine whether they would even be willing to admit her!

    Don't even imagine what the tretment itself would cost!

    Come and live in England! It's all free!

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  • Posted

    River... are you in the US?  I had to pay flor my shingles vaccine because I am not over 60 years old even though it was REQUIRED BY the very insurance company that was denying paying for it before I could get on Humira.  

    However, there are appeal rights here and many times a well-written, threatening letter to the medical group and the insurnace commissioner pointing out circular logic of such a denial, will get your costs paid.

    Also, you generally have annual "out of pocket maximums" with your insurance plan so you should not have to pay more than, say, $4000 per year TOTAL on all medical costs except for drug co-pays.

    Finanally, Yes, in England and Europe, care is all free but, with all due respect to my dear dear friends in UK, i have heard just as many complaints on this forum and others about waiting for care or not having many choices in drugs or physicians if you don't agree with the course your care is taking.  For instance, when many people on this site found out I went straight from diagnosis, to Rheumy appt within 2 weeks and then onto Humira without needing to take any other "step" drugs first, they were flabbergasted.  I felt so BAD for them.  But that is one way the US makes up for some of the bad parts of insurance care here, like cost... you do have choices and if you have a good reasons to refuse - for instance - methotrexate, they will give you and pay for other drugs, like Humira.  

    River, if you are in the US and want some help, I have a lot of experience fighting insurance companies both personally and professionally, on which I am happy to elaborate, if you want some help.  Message me privately.  



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    • Posted

      It's so true about the UK waiting lists.... they can be a nightmare. It took me three months to see my first rehumatologist.

      But apart from that, I believe you have all the choices – or perhaps not all of them.

      But I did read recently that as far as quality of care and treatment is concerned, the UK and, I think, the Netherlands, were at the top of the list and I was shocked to see how low down the US was in comparison (I mean not low as in LOW, but in relation to other European countries).

      FYI not all of Europe has free health care by any means. But many have very progressive deals of one sort or another.

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  • Posted

    WOW !!!!!  That is terrible. I live in Canada and all my labs and Dr. appoinments are covered. The Orencia will all be covered for me , too. I didn't have to wait to see a rheumatologist when I came down with the RA.....but within 10 days of my first symptoms I was a total invalid in bed so maybe that helped in getting me see one so quickly. I am very lucky in that my rheumatologist is only about 3 blocks from where I live.


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