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Hepatitis C Testing & Costs
This is a three part question. Answer any part you may know.
1. Does insurance cover the cost If getting tested (without good cause) for Hepatitis C?
2. What is the approximate costs of a Hepatitis C Antibody test and a PCR (viral load test)?
3. Where can you walk in and say "I want to be tested for Hepatitis C" without a referral?
1. Does insurance cover the cost If getting tested (without good cause) for Hepatitis C?
2. What is the approximate costs of a Hepatitis C Antibody test and a PCR (viral load test)?
3. Where can you walk in and say "I want to be tested for Hepatitis C" without a referral?
Hey there
My insurance covered the cost
Your PCP can request the test
I was tested by a hemotologist (blood specialist) when my platelets fell
My insurance covered the cost
Your PCP can request the test
I was tested by a hemotologist (blood specialist) when my platelets fell
PPS - fat-fingered my original reply, didm;t fully depress the "zero" key. Second paragraph, my out-of-pocket was less than ten percent, not less than one percent.
PS - if you're concerned that your doc won't cut you a lab order, don't see your hepatologist, go see your family doc. In my case, I had a few enzymes elevate after end-of-treatment, and that was my justification for wanting a VL test. He was okay with it - said that made sense to him.
If your physician cuts you lab orders for a viral load test, it should be covered unless you've got a really crappy health insurance plan. Check your benefits booklet.
The out-of-pocket cost to you depends on what the allowable charges that have been negotiated by contract between your health insurer and the provider (the lab) and the particulars of your insurance benefits. By way of example, after the "preferred provider discount" (street price minus allowable charge) and the benefit payable (percentage of the allowable charge) were over and done with, my patient responsibility was less than 1% of the "street price" for my VL test.
Do not call Quest, Labcorp, or other big-name labs like them and ask them what is the cost of a particular test. They will quote you the grossly over-inflated "street price" that they charge the people that can least afford to pay it, the people without health insurance.
Either ask your doctor to ask your insurance company what is the allowable charge for the particular CPT code of the test that you want, or call your insurance company and ask them directly. Concurrently, you could ask what percentage of allowable the insurance company will pay, or equivalently, what will be your patient responsibility. Don't forget to take into account any annual deductible that you haven't met yet!
If and when you decide to get your own private VL test, be advised that several of a lab's quantitative HCV tests, each of which have different street prices and different lower limits of detection and different (lab-internal) test numbers, may have the identical CPT code. So make sure that your doctor's lab orders specify the lab's internal test number of the test you want, so you get the one with the LLOD sensitivity that you want. If your doctor only specifies by CPT code on your lab order, the lab will choose the one that gives them the biggest profit for the price that they negotiated with your insurance company.
Also, be sure that you tell the doctor which test (by lab's internal test order) you want, rather than you want a viral load test. When I got my private EOT+6 Quantasure test, the doctor cut a lab order, at first, for something else that had a LLOD of 100 IU/ml. For a post-Tx assessment test, that would have been worthless. Fortunately, I researched the test, found out how insensitive it was, identified the Quantasure test as being more appropriate, and asked my doc to redo the lab order for that test, which he did.
(Disclaimer: I only cite LabCorp's Quantasure test (test code 140639) here because that test belongs to the lab that my health insurance requires us to use, if we want "in-network" pricing and coverage. If your health insurance prefers you to use Quest (since you mentioned them by name above), you probably want their Heptimax test, test code 10565; it's LLOD is pretty much the same as Quantasure, I think; and both of them are about as sensitive as you can get, if not THE most sensitive that you can get.)
The out-of-pocket cost to you depends on what the allowable charges that have been negotiated by contract between your health insurer and the provider (the lab) and the particulars of your insurance benefits. By way of example, after the "preferred provider discount" (street price minus allowable charge) and the benefit payable (percentage of the allowable charge) were over and done with, my patient responsibility was less than 1% of the "street price" for my VL test.
Do not call Quest, Labcorp, or other big-name labs like them and ask them what is the cost of a particular test. They will quote you the grossly over-inflated "street price" that they charge the people that can least afford to pay it, the people without health insurance.
Either ask your doctor to ask your insurance company what is the allowable charge for the particular CPT code of the test that you want, or call your insurance company and ask them directly. Concurrently, you could ask what percentage of allowable the insurance company will pay, or equivalently, what will be your patient responsibility. Don't forget to take into account any annual deductible that you haven't met yet!
If and when you decide to get your own private VL test, be advised that several of a lab's quantitative HCV tests, each of which have different street prices and different lower limits of detection and different (lab-internal) test numbers, may have the identical CPT code. So make sure that your doctor's lab orders specify the lab's internal test number of the test you want, so you get the one with the LLOD sensitivity that you want. If your doctor only specifies by CPT code on your lab order, the lab will choose the one that gives them the biggest profit for the price that they negotiated with your insurance company.
Also, be sure that you tell the doctor which test (by lab's internal test order) you want, rather than you want a viral load test. When I got my private EOT+6 Quantasure test, the doctor cut a lab order, at first, for something else that had a LLOD of 100 IU/ml. For a post-Tx assessment test, that would have been worthless. Fortunately, I researched the test, found out how insensitive it was, identified the Quantasure test as being more appropriate, and asked my doc to redo the lab order for that test, which he did.
(Disclaimer: I only cite LabCorp's Quantasure test (test code 140639) here because that test belongs to the lab that my health insurance requires us to use, if we want "in-network" pricing and coverage. If your health insurance prefers you to use Quest (since you mentioned them by name above), you probably want their Heptimax test, test code 10565; it's LLOD is pretty much the same as Quantasure, I think; and both of them are about as sensitive as you can get, if not THE most sensitive that you can get.)
pcr tests run about 350.00.. you can get tested at county health dept., if you have no ins
I got all kinds of free labs, by attempting to participate in a Clinical Trial, although I was continually discluded, for having an AST/ALT level higher then the cut-off point,which was a 300/400 ratio,if I remember right.
There are places that do free testing, it differs depending where you are.
For testing sites try: www.hepcchallenge.org
For testing sites try: www.hepcchallenge.org
Ive actually used accessalabs for various tests...very reasonable prices...AND...if they dont have a test on there menu...they will find a lab that does and charge wholesale rate.
1. Does insurance cover the cost If getting tested (without good cause) for Hepatitis C?
Yes
2. What is the approximate costs of a Hepatitis C Antibody test and a PCR (viral load test)?
HCV Antibody test through Accesa Labs $59
http://www.accesalabs.com/STD
3. Where can you walk in and say "I want to be tested for Hepatitis C" without a referral?
AccesaLabs
http://www.accesalabs.com/labfinder
Yes
2. What is the approximate costs of a Hepatitis C Antibody test and a PCR (viral load test)?
HCV Antibody test through Accesa Labs $59
http://www.accesalabs.com/STD
3. Where can you walk in and say "I want to be tested for Hepatitis C" without a referral?
AccesaLabs
http://www.accesalabs.com/labfinder
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