Lab Work

Jul 19, 2007

  1. Golddoor
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    Golddoor Guru

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    Why do most individual plans not cover labs at Doc visits? They do with group plans but not ind plans. That doesn't make sense. I have a lot of people shy away from ind coverage when I tell them that they will recieve a discount on the labs over some one without insurance but you still have to pay your labs.
     
    Golddoor, Jul 19, 2007
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  2. salpro22
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    Quick question if you don't mind. Who exactly is shying away from going onto an indie plan (individual on spouse coverage, somebody coming off a group, etc.)?

    I have no idea why insurance carriers do not cover that in the individual market (NOTE: some plans do cover it at the copay in the mid-atlantic area), however I do know how I overcome that objection.

    I tell people that they still pay for their lab work and other extraneous costs in the form of their group premium because the insurance carrier is able to spread out the cost amongst the group. Personally, I don't like to use the term discount, but prefer to say the negotiated rate. I haven't heard any complaints as of yet for people who have had individual plans. I would be more concerned about "total" exposure vs. the little things.

    People coming off groups can be a PITA and unrealistic about their options, but what are their choices ya know!
     
    salpro22, Jul 20, 2007
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  3. Golddoor
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    Salpro,

    Yes Im mostly talking about people coming of group. Im not saying Im losing people because of it. But I just find myself explaining why they dont cover it a lot!
     
    Golddoor, Jul 20, 2007
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  4. Crabcake Johnny
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    Assurant, Aetna, Blue Cross and Coventry pay for in-office lab in MD at the copay.
     
  5. Golddoor
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    Not sure about BC and Coventry, but I know Aetna and Unicare do not pay for the labs in Texas until deductible is met. Humana pays the first $200.00 at 100% then 80/20 after the deductible which isnt to bad.
     
    Golddoor, Jul 20, 2007
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  6. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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    but the insurance co is counting it toward the deductible right......

     
  7. Crabcake Johnny
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    Heck, in MD Coventry covers in-office surgeries at the copay.

    [​IMG]
     
    Last edited: Jul 20, 2007
  8. wildcat
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    This is a sore point for many IFP clients. Although I don't think it is uncommon for a company to cover the lab and x-ray under the copay when services are provided in the physicians office during the initial visit. However, I don't know of many physicians who have x-ray (radiology) or a lab in their office.

    Hector, here is a slip to go downtown in the next few days to have your blood drawn. (Negotiated rate which goes towards your annual deductible).
     
    wildcat, Aug 3, 2007
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  9. Crabcake Johnny
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    This is where it gets difficult. If your doctor is crammed into one of those medical parks with the 1,500 square foot office he likely doesn't have any equipment. There are other doctors in huge offices that can do everything from bloodwork to xrays right there. I know my wife's OB has everything short of a MRI machine in his office.

    You will indeed be "screwed" if your doctor does not have the ability to do most of his own tests.
     
  10. jacodaro
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    BCBS of AZ, Blue Preferred PPO, lab covered 100% at contracted, free standing independent clinical labs, deductible waived. Hard to beat.