Insuance won't cover tests :(

[Jazziminna 95]

I have Cigna in TX and I went for my initial tests at the hospital outpatient pavilion.(Just getting started) and I was told that Cigna didn't cover any tests for obesity. Not even an A1C test. What? Anyone encounter this? Could someone have possibly coded something wrong? I need 3 blood tests and 2 chest xrays and an ekg. Blood alone is gonna cost almost $1000 if I have to pay myself. They charge a $200 facility fee too. Do you think my PCP could do the tests? He has a lab tech and xray equipment in office. I had to do an ekg and chest xrays 8 months ago when he discovered I was anemic. Or do I have to go to the other place? So bummed. My first dietician appt is on Wednesday and I wanted this behind me but, I guess not.

[wannaBthinsoon 1,634]

the A1C test is for diabetes. They should cover that test. Actually, an annual physical should be running these same tests, and thus covered. Even if your insurance excludes bariatric surgery many of the tests should still be covered. Like the EGD. That should be covered, as a test to see if you have a hiatal hernia, etc. It's all in the CPT code your provider is submitting to the insurance co. (and ICD9 code)

[BLERDgirl 6,417]

Just so I'm clear are they not willing to cover the test at the bariatric center or not at all? I had several of my pre-op test done at a different hospital because that's where my insurance company was capitated to. It wasn't an issue at all. I just had them forward result to the baratric center. Perhaps you could have you primary order or do the testing and then forward it to them.

[Jazziminna 95]

Oh I didn't say this, but they are covering the surgery. So why not the tests? So wierd.

[wannaBthinsoon 1,634]

Ok. color me confused.

[momma_missie 30]

Baffling..

[LSF 264]

I have Cigna and they covered all mine. It's probably your employer, Cigna covers different things based on the company's plan.

[rnsamantha 352]

My insurance only covers the actual surgery as well, but none of the tests or weight loss Dr. appts. I've had to be very careful to have a "complaint" other than obesity at my weight loss appts, my sleep study was covered due to snoring and fatigue, but even my portion of that was over $600. I've had to let my PCP know not to code obesity as the primary diagnosis for visits. I did have to pay for psych evaluation out of pocket ($300). I will need a barium swallow pre-op and I'm not sure how to get that covered. If not, I recommend negotiating a cash price. That's what I did for my psych eval. If they absolutely won't pay for labs, check out Theranos. They are lab clinics located in select Walgreens with very low cash prices. As long as you get the labs ordered sent to your surgeon it shouldn't matter where you got them.