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New insurance and billing...

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Good Morning ,

Beginning this year ( January 01,07 --our company switched over from Cigna to Aetna. I just received a bill from Quest Diagnostics. Apparently , Aetna doesn't cover all of the cost of the 3 month blood tests.

I figured something like this was going to happen, But I am at least prepared. I wasn't quite sure what my out of pocket would be, until now.

Just to give an idea of the cost ; (these were my blood tests were done on Jan 11th.)




Triglycerides ----------------- $ 31.75

Prostate, specific AG--------$100.65 ( that was an expensive one)---once a year


T- CELLS; ABS CD4 COUNT-----$192.46

Comprehen Metabolic panel-----$49.50

Virus -1 quant---------$ 279..50

Grand total-------$807.08 

The amount I have to pay after after Aetna's share is ----- $183.19

I had a feeling that after we switched to Aetna, that I would have to be responsible for some of the costs. It still pays to have insurance. With Cigna, there was no charge for the blood test....


Thank you for posting those figures, Ray. I am on medical disability assistance. I had no idea the lab work is so expensive. WOW!

Ray, that is interesting.....

I wonder just how close you are to qualifying for help from RW.  If you are personally not making a fortune, (please don't count your combined income) it might be time to start looking into signing up and maybe get some help.  What I am talking about is help with the co-pay.  I know here in Arizona, if a person is not above the income limits that we pay for co-pays for this type of expense for those that are self insured, or work insured. 

The reason for this is that it is recognized that many are functionally working and have insurance, but sometimes now the cost of meds and co-pays really causes one to go into poverty to keep up.  This would start a chain reaction that might cause the person to end up being on Ryan White for everything due to insurance or job loss.  Paying co-pays for people like you, keep you on the road to independence and that is the reason it is approved. 

I would suggest that you all look into this little known fact.  (not all states do this)


Hey Ray,

What Tim said regarding insurance assistance. Here in New Mexico, it isn't Ryan White but the ASOs who pay this through other funding, part of which probably comes from Ryan White, but that's another issue.

With my ASO, the rule is you are eligible for insurance assistance if you are on ARVs and earn less than 300 percent of poverty.

What Tim said about not counting your lover's income is important too. Since gay men cannot marry, your partner's income isn't considered with this program - and some others. (It is different for HOPWA, but that's another story.)

Anyway, its food for thought. I'm sorry you are being stuck with these co-pays. So far (knocks wood) mine are still fully covered.



Thanks Tim,

I just went online and paid that $183.19 bill to Quest. HOWEVER, after I paid that, something just didn't seem right to me. So I called Aetna....

I just got off the phone with Aetna, and they told me that my co-pay ( total  out of pocket should be only $50.00. That they ( Aetna)- are to pay that $ 183.19. At least that is the way I understood it, from the conversation I had. But apparently, Quest has not received payment yet from Aetna. OH BOY !!.... HERE WE GO... !!!!  :P :P

I then called Quest Diagnostics, and they told me that if/when Aetna sends them the money, that they would refund the $183.19

I really hate dealing with insurance issues. This stuff makes me crazy.

Meantime, I have a Quest diagnostics office , right across the street from me. I think I will go over there, with the information I have, and see what they have to say. Trying to talk, to these people on the phone, and understanding what they are talking about is almost impossible !!! I am sure you know what I mean !!!

Thanks for the RW information, but right now, I probably don't really need to use RW. I am not making a fortune, but I have been very careful of expenditures these past few years. I'll see what happens here first, with Aetna, and see how this resolves.

Thanks Tim-----Ray


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