$500 bill for basic blood screens at annual physical

[Anonymous]

My BCBS high-deductible plan covered the "visit" portion ($200) of my annual physical, but covered none of the associated blood tests: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), Lipid Panel, Hemoglobin A1c (HbA1c), Thyroid Stimulating Hormone (TSH). Just the basic stuff, no vitamin panels or anything exotic. Total cost was $700, with the insurance negotiated rate bringing it down to $500. I don't understand how insurance is allowed to not cover these sorts of basic screens. No wonder most Americans are so unhealthy. How many can afford a $500 bill when they aren't even sick?

[Anonymous]

This should not have happened. Fight it.

If you exhaust all means to fight it, tell the billing office what you're willing to pay. They'll probably take it and close the matter.

[Anonymous]

High deductible plans don’t seem like a good idea. How high is the deductible?

[Anonymous]

Anonymous wrote:This should not have happened. Fight it.

If you exhaust all means to fight it, tell the billing office what you're willing to pay. They'll probably take it and close the matter.

Not op but how exactly do you fight this if these tests were indeed not covered under OP's plan?

[Anonymous]

AI Overview

No, High Deductible Health Plans (HDHPs) typically don't cover blood tests and other routine medical care until you've met your deductible. HDHPs are known for having higher deductibles than other plans, and are sometimes called "catastrophic coverage" insurance.

[Anonymous]

The deductible is essentially your annual premium.
Pay it.

[Anonymous]

Anonymous wrote:The deductible is essentially your annual premium.
Pay it.

Yep, this is always how I evaluated HDHPs vs PPOs - the yearly HDHP deductible vs the yearly cost of the PPO.

[Anonymous]

(provider)

BCBS, especially plans administered out of state, have created their own list of admissible diagnostic codes.
It's a scam, they are also barely covering our patients' basic prenatal labs (we are an obgyn group)

Here is what one smart patient did
Request a list of acceptable codes that they are willing to process (CPT codes)
Bring like a cake to the office because you are asking them to work for free, and ask them to re-code your visit and labs from that list
It will have a different identifying number for annual exam
We are all amazed it's legal, they just went ahead and invented their own CPT system it looks like without any informed consent from ANYONE

Anyway, my patient's labs got covered that way.

I am guessing someone at some point will be fed up, will take them to court, and they will immediately fold and stop it
But until them, they will collect $500 for basic annual labs from lots of people who do not know better, and cause all of use in healthcare to lose their minds adjusting all the bills to their new, unannounced, and probably illegal system.

Rant over, please get a nice cake for your PCP's office... veggie tray will also work

[Anonymous]

I’ve never had my insurance pay for bloodwork. With my dr who didn’t take insurance and had an in house lab, I paid about $1000 for a checkup, ekg and bloodwork. Down to a few hundred when I switched to an in network dr, but the level of care is greatly reduced.

[Anonymous]

Annual physicals are supposed to be 100% covered since they are preventative, but it turns out it can’t be part of another complaint. If you go to the doctor and say this or that hurts, and he says ok let’s do your annual physical since you’re due, they won’t consider it as a preventative. You have to say I want my annual physical and nothing else. I have ended up in the same boat as you a few times because of that. It’s bs.

[Anonymous]

It’s because you have a plan with a high deductible. This isn’t rocket science.
Choose a plan with a low or no deductible and pay more towards it monthly or stop complaining. You chose the plan you have.

[Anonymous]

Welcome to America.

[Anonymous]

Anonymous wrote:Annual physicals are supposed to be 100% covered since they are preventative, but it turns out it can’t be part of another complaint. If you go to the doctor and say this or that hurts, and he says ok let’s do your annual physical since you’re due, they won’t consider it as a preventative. You have to say I want my annual physical and nothing else. I have ended up in the same boat as you a few times because of that. It’s bs.

Right but those lab tests should be part of an adult physical, especially middle aged or older. Do they expect you to forgo the blood tests and then suffer the consequences (and financial costs) of uncontrolled diabetes because it wasn’t discovered earlier?

[Anonymous]

Anonymous wrote:(provider)

BCBS, especially plans administered out of state, have created their own list of admissible diagnostic codes.
It's a scam, they are also barely covering our patients' basic prenatal labs (we are an obgyn group)

Here is what one smart patient did
Request a list of acceptable codes that they are willing to process (CPT codes)
Bring like a cake to the office because you are asking them to work for free, and ask them to re-code your visit and labs from that list
It will have a different identifying number for annual exam
We are all amazed it's legal, they just went ahead and invented their own CPT system it looks like without any informed consent from ANYONE

Anyway, my patient's labs got covered that way.

I am guessing someone at some point will be fed up, will take them to court, and they will immediately fold and stop it
But until them, they will collect $500 for basic annual labs from lots of people who do not know better, and cause all of use in healthcare to lose their minds adjusting all the bills to their new, unannounced, and probably illegal system.

Rant over, please get a nice cake for your PCP's office... veggie tray will also work

I don't think any health care provider will be willing to risk their license or assume liability for their practice by coding something that did not happen, much less for a tray of sweets

[Anonymous]

My son just turned 18 and when I was expecting him I paid $1000 for the blood screens

$500 these many years later is small fry.