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I'm trying to determine what (if anything) my insurance can help me with.

Tests. This seems to be very unclear. I did manage to confirm that my PCP doctor has to order the tests for them to have a chance of being covered. Beyond that, I hope my PCP doctor can tell me more.

If I am paying the full cost, the costs look like:
  • Blood tests: 
    • Without insurance done @Clinical Pathology Lab: $1871.75
    • PCP doctor ordered tests for me!
    • PROBLEM SOLVED. Even if the test isn't covered, I will still only have to pay the negotiated rate for the blood work. I guess if it's not covered, it won't go toward my deductible, but I still get the cheap rate.
  • Lyme panel & Co-infection panel: $1194
    • "IGeneX has not contracted with any insurance companies. Therefore, we DO NOT bill patients’ health insurance for any testing performed through IGeneX."
    • Going to put this test off for now. Eventually will need to see if insurance covers it. If not, need to see if IGeneX has a billing plan or coupon.
  • Organic Acids urinalysis / OAT: $381
    • Talked to Brea in Billing. They are an out-of-network provider for my insurance. I send in the $381, and if my PCP orders the test for me, they can bill my insurance $1000+ for the cost of the test, and see if insurance will pay it. But I never have to pay more than $381. Basically, there's no break or discount here.

Prescriptions / Supplements. The prescriptions are the same cost to me whether or not they are written by my PCP doctor or my integrative medicine doctor. My insurance gives me a negotiated rate, but I must pay all of that rate. All prescription payments count toward my yearly deductible.

  • Through insurance: $171.17 $40 with coupon for a 10 day supply
  • I have 2 refills. I don't know yet if I will need to use them.
  • There is no generic, but there is an alternate drug. I don't know if it's safe to start a different drug after using the first. They could have interactions.
    • Neomycin-polymyxin-HC (generic of Cortisporin): $69.88 for a 30 day supply
  • PROBLEM SOLVED. GoodRx found me a manufacturer's coupon. $135 off all refills. My Ciprodex coupon info.
    • The full amount will get applied to my deductible!
  • Through insurance: $446 for a month supply
  • PROBLEM SOLVED. Through Foundation Care pharmacy (in partnership with EnteraHealth): $49/month
  • Will need to be taken 6-8 weeks just to see any effects. Prescription is for one month supply with 11 refills.
NuMedica Micellized Vitamin D3 1200 IU drops
  • On Amazon: $27.50 for a 1 oz bottle (90 day supply).
  • On special discount website my integrative medicine doctor provides for his clients: $27.50 + shipping
    • I can get free shipping & a 5% discount if I have it auto-shipped to me every 90 days: $26.13
  • On Professional Supplement Center: $23.50 + shipping
    • Some kind of "rewards" for auto-shipment

I've never spent this much on health care. I'm really starting to worry if I can afford to be healthy.


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August 2016

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