Medicare covered tests?

[Lisa]

Hey Everyone!

Getting ready to begin searching for answers to my health with a new physician, this time a naturopath. I've had some various testing done over the years, but mostly common things like thyroid and vit D levels.

I'm wondering what sort of tests I could be asking to be run that might help pinpoint future treatment better - specifically that are covered by Medicare.

All the common symptoms - fatigue, PEM, OI, non-restorative sleep, low thyroid but not very low. Also MCS.

Will be testing thyroid, vit D, progesterone/testosterone, K2 as usual. Will add a MTHF test to it as well this time, will be first time testing it.

It's been at least 6 years since I had a regular blood count panel run, was thinking of doing that - are there some boxes I should make sure are checked on it which don't always get checked?

Highly likely to be running a lyme panel as well, the Igenex one as it's covered.

Possibly ferritin levels tested too.

Any good adrenal/cortisol panels covered that people know of?

Thanks for any help! Lisa :Retro smile:

 

[xchocoholic]

Hi Lisa,

FWIW ... You and I have the same symptoms ... ; )

Medicare covered my CDSA, Spectracell nutritional panel and Genova hormonal testing .. oh and all the regular traditional tests too.

You may want to get your pregnenolone tested. Mine was really low so I supplement now. And your doc may want to test for Thyroid antibodies not just your hormones.

And FWIW .. I just learned that I'm extremely caffeine intolerant. I've only been caffeine free for 2 weeks but I'm already feeling a little better. My hope is that it will help my OI.

tc ... x

 

[caledonia]

I had a sleep study covered. They whined about it, but they actually did pay for it.

 

[Mya Symons]

Somehow my sister-in-law is able to see an infectious disease doctor regularly. She has been diagnosed with ME and nothing else, so this is pretty miraculous, I think. He has done all kinds of tests on immune cell function and viruses which medicare has paid for. It could be because she has been in the hospital alot (She has had sepsis more than once). However, I think if you have a good enough doctor who is willing to go to bat for you, medicare will pay for the tests you need.

 

[*GG*]

Somehow my sister-in-law is able to see an infectious disease doctor regularly. She has been diagnosed with ME and nothing else, so this is pretty miraculous, I think. He has done all kinds of tests on immune cell function and viruses which medicare has paid for. It could be because she has been in the hospital alot (She has had sepsis more than once). However, I think if you have a good enough doctor who is willing to go to bat for you, medicare will pay for the tests you need.

Wow, your sister was actually diagnosed with ME in the USA? That sounds very rare?!

GG

 

[Lisa]

Wow - thanks for the quick replies!

I will look into the Spectracell and other tests - last year I had to pay out of pocket for the Spectracell one and can't afford that again, but perhaps they have become covered since!

I too am very caffeine intolerant, same with alcohol. It's been years since I had a real cup of coffee. At this point decaf wires me as much or more than a cup of regular coffee used to. Even raw chocolate's (cacao powder) minor amounts of caffeine have a noticeable kick if I indulge in more than a dash or two.

I guess all this really means is that I'm a cheap date.

Thanks! Lisa :Retro smile:

 

[Mya Symons]

Wow, your sister was actually diagnosed with ME in the USA? That sounds very rare?!

GG

Yes. I think she gets so much help because she seems to not have much of any immune system anymore and is always in the hospital. I think this is why the infectious disease doctor took so much interest in her. She also has a doctor who immigrated to the USA for the Soviet Union and seems to be so much more understanding then any American doctors.

 

[Lisa]

Update on Spectracell and Genovia testing - medicare cuts have affected how much of their testing is still covered.

Also the testing needs to be issued from an M.D. for any of it to be covered, meaning though my naturopath can order the testing it won't be covered at all by medicare.

Example:
Comprehensive Nutritional panel from Spectracell - approx 33 different tests on it.
Covered by Medicare in 2011 - 7 of the tests
Remaining balance out of pocket - approx $150

I haven't spoken directly with someone from Genovia as I did Spectracell, but the info on their website mirrors what I found out from Spectracell regarding medicare approved physicians needing to issue the test order.

Back to the hunt for covered testing! Lisa

 

[taniaaust1]

I too am very caffeine intolerant, same with alcohol.

With the MCS and the alcohol intollerance and it also causes intollerance to other things. Thou it isnt covered by medicare seeing you are seeing a Naturopath, I suggest to ask about hair analyses testing.

I recently had hair analyses testing done and they tested a lot in that eg heavy metals, trace minerals etc etc and it was actually far cheaper then I thought it would be for the amount of things tested for. This test showed a had almost a nil level of an essential trace mineral (molybdenum) which is responsible for helping make a couple of enzymes in the body including the enzyme which helps break down alcohol and some other chemicals eg I also had issues with saccharin/artificial sweeteners which also needs that enzyme to help break down that chemical.

Since Ive been supplementing molybdenum and trying to fix the deficiency along with selenium (as my tests also showed high copper and the selenium helps with that) I was feeling an improvement after only 5 days on my new supplements. I can now think and focus better then I could for many years. .. Anyway.. you may want to check to make sure your MCS and alcohol issue isnt being made worst or being caused by molybdenum deficiency causing your body not to be able to break down things.

 

[Lisa]

Hair analysis, good idea. I've had one about 6 years ago, might not be a bad idea to get that updated.

No worries on the molybednum, been supplementing with it for a few years now. It seems to help with a few symptoms - especially when the MCS is triggered by sulfur based problems (fireworks, etc).

Update on stuff covered:

I had blood drawn yesterday and the hospital couldn't say for sure that Medicare would cover the Vitamin D or lipid panels. The last few years Vitamin D testing has been covered without trouble, but even trying 7 different diagnostic codes wouldn't clear it for the computer system this time.

Also was surprised, this was the first time I was given a form to sign saying I would pay out of pocket for those two tests and appeal with Medicare. The way it was worded, it was hard to say if they'd even try billing Medicare before sending me a bill.

In the end, skipped the Vitamin D panel ($350!), but took the lipid panel ($130).

Pretty ridiculous that liver function testing (lipid panel) and Vitamin D testing isn't considered necessary to CFS/MCS... especially the liver functions when dealing with an illness which has a major symptom of sluggish detox!

Other general blood tests that were covered: Ferritin, sex hormones, DHEA, CBC, Comp metabolic panel, various thyroid, MTHFR (c644t & a1298c), Vitamin K.

Also had lyme testing run through Igenex. The complex panel is fully covered by Medicare B insurance. The co-infection babseia FISH (sp?) panel has a co-pay on it, all they could say is it would be no more than $150 - it depended on how much my medicare deductible had already been met this year. Still, about $1000 worth of testing and most of it covered.

Just a note - I had to have my specialist issue the labs as the naturopath issued labs would not be covered by Medicare. I'm also hearing that they are expanding this to include not covering testing and prescriptions issued by M.D's who refuse to enroll in Medicare.... Yikes! Considering few, if any, CFS or MCS specialists accept Medicare, this could become a very sticky situation for many.

 

[taniaaust1]

Just a note - I had to have my specialist issue the labs as the naturopath issued labs would not be covered by Medicare. I'm also hearing that they are expanding this to include not covering testing and prescriptions issued by M.D's who refuse to enroll in Medicare.... Yikes! Considering few, if any, CFS or MCS specialists accept Medicare, this could become a very sticky situation for many.

It sounds as if the health systems all over the world are just getting worst.

 

[Lisa]

Aye, I was sorry to hear of your own insurance changes too.