LymeNet Flash: Medicare No Longer Paying For Igenex Tests?

This is topic Medicare No Longer Paying For Igenex Tests? in forum Medical Questions at LymeNet Flash.

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Posted by riversinger (Member # 4851) on :

My LLMD apparently told a friend of mine that Medicare is no longer paying for Igenex tests.

Has anybody else had this problem? Is it only true in CA, or only for some people? I just had tests done in September, of which at least some have already been paid, so this must be very new.

If true, this will be a tragedy, as so many with undiagnosed Lyme are already on Medicare.

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Sonoma County Lyme Support
[email protected]

[This message has been edited by riversinger (edited 13 November 2004).]

Posted by nan (Member # 63) on :

I just had the full battery of tests in October and they were all covered.

As far as I know Medicare coverage is the same from state to state. I sure hope so!

[This message has been edited by nan (edited 13 November 2004).]

Posted by ArizonaLisa (Member # 6501) on :

I had some tests done in July and I haven't heard anything so I HOPE they are being paid for.

Does anyone know if Medicare pays for MDL Labs and Stonybrook tests? I hope so because I just had some of these. With, I have to add, COMPLETELY different results from the IgeneX ones. Not sure what to think about that. Lisa

Posted by riversinger (Member # 4851) on :

Igenex uses 2 different strains of Bb for their western blots, unlike any other lab, so it may well have different results. Many people have had blood sent to multiple labs with different results coming from each test.

From what I understand about Medicare, if the lab doesn't have you sign an advance benificiary notice (ABN), then you are not responsible to pay for the tests, whether Medicare pays or not.

The lab is responsible for knowing whether Medicare is likely to pay or not, and has to inform you of that. Then you have the choice to go ahead with the tests and pay yourself, or to refuse them.

I'm just trying to find out if Igenex's status has changed, or if what I heard was a mistake.

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Sonoma County Lyme Support
[email protected]

Posted by rosesisland2000 (Member # 2001) on :

If this has happened then it must have been recently, for they paid for mine in June.

Rosemary

Posted by bg (Member # 46416) on :

River,

We are waiting the results of my husband's Aug. western blot tests by IGX....they told me they would file for medicare.

Would you like to call & ask them personally? We're just waiting to hear what happens before BLUE CARD will pay a small minimal amount like this did with me....$34 vs. $180. Betty G., Iowa

Posted by Laurie (Member # 159) on :

Madicare paid for a full battery of tests I had done in August sent to Igenex.

I'm not aware that Medicare can pick and choose which facilities they'll pay for, only which procedures they'll pay for.

Posted by Barngirl (Member # 6391) on :

My Mother had her tests done in August I think and Medicare did not pay for Igenex.
But she had a spinal tap done and sent some fluid to Igenex. Medicare completely covered it.

I don't know how they figure it out. You think it would be completely covered.
My insurance will not cover it.

Posted by riversinger (Member # 4851) on :

Well, I don't know what the basis of my friend's comment was. We contacted Igenex, and they are still paid by Medicare, just not paid well.

I'll see my doctor this week, so will try to find out what was really said.

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Sonoma County Lyme Support
[email protected]