Lab tests I didn't know the DR was doing....now I have 4K in out of pocket expen

[scottieman]

OK, I just got a bill today for some lab tests my dr did back in October.....my out of pocket for this bill is $2,500 on top of the 800 I already paid out of pocket for the other tests he did back then.  He did a set of tests the begin of January, which I assumed would only be a cd4 and viral load (since that's what we talked about) but nope.....I got a bill for 11 different labs....another 800 out of pocket.

Why would my DR order tests we didn't talk about, and am I really responsible for these?  This is among some other issues I've had with his office, so I am changing primary Dr's for  my appointment in March. 

I understand HIV is an expensive disease, but really why all the extra lab work???

[buginme2]

The initial lab tests after testing positive are quite extensive. They usually include a CBC, Chem, HIV viral load, CD4 count, resistance test, std panel, HAV/HBV/HCV, and maybe a tropism and some other tests.

If you do not have insurance that coves these you may want to look into the possibility of some state assistance. 

During that first year, until everything stabilized, I had lab tests done every three-four months.  Even now I still get viral load, cd4, CBC, chrm, maybe a lipid panel a least twice a year.  Without knowing the specifics of what was ordered its hard to say if the tests weren't appropriate. You should have at least been told what the are doing.

[scottieman]

Thanks Buginme2, I do have insurance with a HIGH deductible.  I suppose it would have been wise of me to investigate the cost of these tests and perhaps waiting until Jan 1 to have started doing anything. That would have put all the initial stuff against one calendar year deductible (7,500.....UGGHHH)

[buginme2]

I just checked online for when I tested positive and just the HIV resistance test was charged at $1700.   

A $7500 deductible?  That is absolutely insane.  That's not insurance, that's extortion.

[scottieman]

Yes pretty much is, I have an individual plan since my employer does not provide insurance....the deductible is high, the premium is high, and it covers very very little.  The job search is on, and it's a fundamental shift in thinking for me to make the benefits the prime priority.

[LiveWithIt]

My friend doesn't have good insurance and he started getting bills for lab work, I told him to call them and just send a small payment like $10 a month.  They really do bump up those bills.  They charge more because Medicare and Medicaid pay so little.  I would tell the doctor to let you know what tests he's doing and get preapproval for them.  Don't feel obliged or get stressed out  to pay stuff off when you can't afford it.  Luckily I have Medicare and they pay for almost all tests, any test I have to sign for or that are not covered I decline to pay for at Quest.

 I did get a bill for a PSA test which is for Prostate problems because it runs in my family and Medicare won't pay for it if you are under 50, so now I have to bother my doctors office to file and appeal on my behalf, and the billing department at the doctors office basically said she doesn't care about outside bills, only money due to them and told me to get the nurse to do it.  Medicaid in Florida is shite, they won't pay for anything, although they are supposed to pay my copays.  When I lived in the Northeast our  Medicaid was great, they even covered some dental work.

[osric]

Yeah I had the same experience. And I have a friend that this happened to as well. I am in so much debt and so underwater that I just call them every time hey send a bill and give them my sob story. Sometimes I feel bad for the billing person. But not that much. it's like the credit card companies who try to set a minimum payment. They don't want to take my $50 a month, they want $150, so I just send them a check for $10 and they still pile on the late fees. Fun. I get the same treatment from the labs that do all the bloodwork (and their collection agencies).

Thankfully I now have coverage through ADAP and the state insurance program here to supplement the private insurance I already have. It's a weird complex mess but somehow it works out that I don't have to pay anything out of pocket. I also make less money than I did 25 years ago, so at this point I'll take any help I can get.

But yeah the doctors and lab techs have no idea what all these tests and meds cost, and I don't think they really care. My neurologist just referred me to another neurology specialist and wants me to get another EEG and another MRI. It's not like these are frivolous office visits or tests but good lord the costs pile up and it's no wonder there's a health care crisis in the US.

Ok I kind of lost the plot here but I empathize with you. Getting sick and going into debt to pay for healthcare was never part of my life plan.