Is lab work covered by insurance?

I'm a little over 3 months out (and 40 pounds down!) from a DS and recently visited my family doctor for the first time since I had surgery.  I wanted him to order lab work and also to have him review the vitamins and supplements that I'm taking.  (I've gone to him for a several years and I really like him.) 

However, his response completely shocked me.  He said he'd order whatever blood tests I wanted but that my insurance wouldn't pay for them because they weren't necessary and I'd be out $1,000.  Plus, he said that since I had been taking a lot of vitamins and supplements that the results would be skewed as a result and they'd be worthless!

He never even asked me about the surgery or acknowledged my weight loss.

So I left without an order for labs and was really upset at his response.  In retrospect, I can't help but wonder if his own struggles with weight colored his response.

Anyway, it's clear that I need to find a new doctor.  In the meantime, I've started seeing a nutritionist who specializes in WLS patients.  Her input has been extremely beneficial and she's helped me better align my vitamin and supplement intake to what is required for DS patients.  She also provided me with a list of labs that she'd suggest having done.

I'd really like to know what others' experiences have been in order to have the necessary lab work done.  Was it covered by insurance?

I really like my PCP also, but it doesn't make them any less useless when it comes to WLS. Most have little to no understanding of the various procedures, especially anything to do with a DS.

If possible, use your surgeons office to order and evaluate the lab work. You will need detailed lab work that most PCP's won't even think to order.

Insurance should cover the tests, but maybe not at 3 months. 

Get your surgeon to order your labs. Mine does and then I share the results with my PCP. My insurance covers my labs 100%.

Thanks Laura.  I'm not sure if this would work as I went to Mexicali for my surgery.  Would a lab here in the US take a script from a Mexican surgeon?

Your pcp (or new pcp) can order your labs for a malabsorptive condition, which you  have. I don't know whether or not a lab here would accept a script from a non-US doctor, and I would strongly suspect that your insurance wouldn't cover anything ordered by a non-US doctor, but I also strongly suspect that your current pcp is very wrong about your insurance not covered labs that he orders, assuming he codes everything correctly.

    What it sounds like is that he can't be bothered to learn anything about your surgery, and why you need certain lab work, which is a shame. Unfortunately we see this all the time. Your choice is to either stick with him, given that he is at least willing to order the labs for you, or to find someone new.

Larra

Thanks Laura. 

I've made up my mind that I'm going to find a new PCP. I'm going to start by calling around and asking to speak to the nurse first to find out if the doctor has any experience with DS and if not, would he/she be willing to learn.

I also read elsewhere on this forum that it's helpful to explain to the doctor that your malabsportion issues are similar to those with "short gut syndrome."  (I'll certainly mention that.)

if you insurance doesn't cover Wls,it likely won't cover many of the labs needed. It should still cover the basic labs,though.

you ca go to online labs ,I think one may be labs online.com or something but you can google it. You check the labs you want,one of their online docs writes an order for them and you take the order to you nearest lab affiliated with the online lab for the draw,then you get your results. 

This is what I would do if necessary

So strange that your insurance will not cover labs, but does your doctor know to code your diagnoses so that certain labs are covered. I have never had to pay for any labs. and 10 years out from WLS (first RNY and then DS)  I am on Medicare, if that has anything to do with it, I don't know. If the codes on the lab slip reflect what the labs are, they will be covered. I have one diagnosis of Vitamin malabsorption so any vitamin labs are covered, I have a thyroid issue so thyroid testing is covered, I have postop weight loss procedure and labs for that are covered (many are overlapping). Unless your insurance really does not cover labs, that can be an issue for you I guess. Have you ever had to pay for any labs before? You can call your insurance and ask them directly if they pay for labs or what they do not absolutely pay for and then you can relate that info to your doctor. Start there. Good luck.

I've found a new PCP that I'll be seeing for the first time later this week. According to his nurse he sees WLS patients. I'm hoping he knows something about DS and will know what labs I need and how to code them.

I just think that my (former) PCP didn't want to go to the trouble to learn anything about DS.