Getting Insurance To Cover Lab Tests W/o MD?

[dfspcc20]

Does anyone have experience ordering lab tests on your own *and* having insurance cover it? Or is that an oxymoron (at least in the US)?

My naive understanding is that for the cost to be covered (at least in part) the labs have to be ordered by a licensed physician, either as part of "preventative" care or for a diagnosed condition.

 

[dbh25]

No, I pay out of pocket. But it's convenient and not that expensive through websites like, privatemdlabs.com

 

[Dan W]

DirectLabs has always hinted that it might be possible to get insurance to cover them ("...we can provide you with CPT codes so that you may file for reimbursement"), but I've never heard of anyone that's done it.

 

[dfspcc20]

@Dan Wich
AnyLabTestNow has that they can charge it to a Health Savings Account, so at least we can get the tax savings (if you're fortunate enough to have an HSA). They also have vague language about it possibly being reimbursed by insurance.

ANY LAB TEST NOW® does not accept medical insurance. In some cases, your lab test and its payment may be accepted and reimbursed by your insurance company in accordance with the terms of your policy. Please check with your insurance company.

Cash and all major credit cards are accepted. ANY LAB TEST NOW also accepts most health savings account credit or debit cards associated with a major credit card.

(www.anylabtestnow.com in case you want to add that to selftestable)

So I'm assuming self-directed lab testing would be considered an "eligible expense" for an HSA. Not sure about Flexible Spending Accounts (FSA). Maybe our resident accountant @GAF can clear that up?

 

[Dan W]

Very interesting, thank you.

The IRS says "you can include in medical expenses the amounts you pay for laboratory fees that are part of medical care." It seems like that last part leaves some ambiguity if it's not through a doctor...

It looks like several of the companies (Health Labs, True Health Labs, Health Testing Centers, EverlyWell) explicitly say they accept HSA's. But some of them mention it being your responsibility to check for eligibility.

 

[GAF]

Any flex plan would pay that.

 

[tankasnowgod]

Very interesting, thank you.

The IRS says "you can include in medical expenses the amounts you pay for laboratory fees that are part of medical care." It seems like that last part leaves some ambiguity if it's not through a doctor...

It looks like several of the companies (Health Labs, True Health Labs, Health Testing Centers, EverlyWell) explicitly say they accept HSA's. But some of them mention it being your responsibility to check for eligibility.

I just got a HSA this year, along with a debit card, and I have ordered from Direct Labs.