Gift of Hope monthly blood draws

[MooseMom]

How much do y'all pay for these monthly blood draws (assuming you are a home patient, ie not in-center)?  My coordinator warned me that there would be a nominal draw charge imposed by the lab, probably $10-$20.  I was shocked and appalled to discover it would be $40!!!!  Each month!!  That's $480 per year for a procedure that takes all of 15 seconds!  And of course, insurance doesn't cover it.  And of course, I am compelled to do it because if I don't, I'm off the list.  I thought this was outrageous!  What do you all pay?

[paris]

My insurance pays for my labs.  Thank goodness!   I get them 2 or 3 times a week right now.   Does your insurance pay for any blood work?  This really does stink.  All these charges add up.

[cariad]

Absolutely nothing! I've never heard of insurance not covering this. Gift of Hope supplies the vial and the packaging so there is no cost to the lab. Do you get other monthly labs drawn? Could you just schedule it all at once and then ask that they just tack it on the end and not charge? Would your nephrologist draw it for free? (My GP drew mine. I know, doctors are usually the worst at this because they rarely have to actually do it, but I used to have easy veins. Ha! Those days are over.)

I thought it was pathetic that I had to pay my own shipping for Gift of Hope bloods, but just as I stopped needing to get those draws, they started picking up that cost. I was enraged that I had to be out $6 or so for the two bloods I did actually send back. I think I would be drawing up protest signs to go picket my insurance company if I were in your position!

[jbeany]

I never paid a dime for any of it.  The transplant hospital send boxes with vials, shipping packages and pre-paid shipping labels.  I didn't start until I was on D, so I just had it done with the rest of my monthly labs.  When I was in-center, they even took care of packaging and shipping drop-off for me.

[okarol]

Jenna's labs were done every month at the dialysis center and were paid for by insurance and medicare. If she didn't have private insurance she would also qualify for state medicaid. I don't think we paid anything. Hopefully she will get listed again. Not sure how the labs (she gets the monthly now, but not sent out, no PRA tracking yet) will be handled.

[MooseMom]

All of the packaging and shipping costs are free (which I gather is a fairly new service as Cariad pointed out).  I have my blood drawn every other month as mandated by my neph, and THOSE labs are covered, so on those occasions, I get the GOH blood drawn, too, and the nice lab lady doesn't charge me (we're on first name terms since I'm in there so often!).  But that means that every other month, I still have to pay $40.

I'll ask my husband to sort this out as he is the world's greatest schmoozer.  Maybe he can have a word with BCBS.

I suppose that if I were already on D in-clinic, the GOH draws would be done along with the usual draws, and there would be no charge.  But right now, every other month there is no other reason for me to get blood drawn, and since GOH isn't a physician who is authorized to order blood draws and labs, my insurance won't pay the "blood draw fee."

Does this make sense?  It DOES make sense to me, but I resent being coerced into paying this much money.  I'd be OK with 10 bucks, but $40 is a bit OTT.  Any suggestions for what I should say to BCBS to get them to cover this?

[Jie]

Normally, insurances cover the drawing fee only. A lot of clinic do not charge any handling fee, so for most patients, it is basically free. My family doctor's office charges handling fee as well, which I strongly oppose. They do not handle anything. They argued with me that once the tech touches a tube of blood, it is handling. It is ridiculous. A $40 seems to include both drawing and handling fees.

[MooseMom]

Normally, insurances cover the drawing fee only. A lot of clinic do not charge any handling fee, so for most patients, it is basically free. My family doctor's office charges handling fee as well, which I strongly oppose. They do not handle anything. They argued with me that once the tech touches a tube of blood, it is handling. It is ridiculous. A $40 seems to include both drawing and handling fees.

No, there was no mention by the lab of a "handling fee", only a drawing fee.

Side note...my husband contacted BCBS and explained the situation to them, and they seemed to say if I could get a referral from my neph requesting these draws, then BCBS might consider covering it.  So DH is going to speak to the neph's PA and see if we can get a formal referral (I'm on an HMO, so the referral is king).

[paul.karen]

I dont pay anyhting either.

But if i go out of network i would have a co-pay.

Before i started dialysis i saw my neph once a month.  And his co-pay was $50 as he is a specialist.
Now that i am on dialysis and i see him at the clinic once a month i dont have to pay a dime 

Hope you get it figured out MM. 

[MooseMom]

It will be interesting to see what BCBS has to say and what reason they will give for not paying for it.  I suspect that they will say that since GOH is not a physician, per se, then insurance coverage does not apply.  I don't know if they really will accept a referral from my neph like they suggested because some other insurance bureaucrat can say that my neph isn't asking for blood to be drawn for his purposes; I don't know if a doctor can order a lab test on behalf of a third-party organization like GOH.  I am REQUIRED to have this blood drawn or else I don't get treatment (a transplant); this is not elective on my part.  There are some fundamental issues here, and I'm really curious what the outcome will be.  Forty bucks a month isn't much for BCBS, but that money would cover a lot of the co-pays for numerous meds!

[MooseMom]

OK, here's a bit of an update.  My neph's nurse (who is always very efficient and nice to boot) called me today to discuss a referral.  She had no idea how expensive the blood draws were, and to surprise, she didn't seem to understand what the monthly draws were for.  She asked what kind of tests GOH ran on the samples.  I had to explain to her that there were no tests per se (like the sort of labs the neph would request), but that the samples were tested for antigens to compare to a kidney that had become available.

My argument is this...my neph has decided that for me, the best treatment for my CKD is transplantation.  In order to have said treatment, it is required that I have monthly blood draws, therefore the expense should be covered. 

Any thoughts?

[paris]

I just don't understand why they are making this so hard for you.  My tranplant center sent me a box with all the red top tubes for collection and a mailing box, prepaid postage.  My GP's office did the draw, mailed the box.  I paid nothing. I did this for years and never had a charge.   I wonder if being on the list makes a difference?  As soon as I was listed (5 years ago) they started the monthly draws.   I will keep watching this thread because now I am really curious.  Is anyone else on IHD having or had a similar problem?

I hope this gets settled soon for you, MooseMom.   

[MooseMom]

Maybe it's just a function of where you live, I don't know.  My box with the red top tube doesn't come from the transplant center, rather, it comes from an organization called "Gift of Hope".  It is a federally designated not-for profit organization that coordinates organ donations in the N. Illinois/NW Indiana area.  It is not specifically affiliated with my transplant unit at Rush University Medical Center.  Apparently, postage used to be the responsibility of the patient because on the information sheet that comes with the box, it says "NEW SERVICE" and goes on to explain how to package the vial and send it back with a prepaid packing label they provide.

I've been listed only since 27 July, so have had only two monthly draws so far.  I go to the very same lab that I go to when I get my regular bloodwork done; as a matter of fact, it is just across the hall from my neph's office.

The procedure is fairly streamlined.  I go get blood work done every other month, so having to go each month now  for GOH purposes isn't that big of a deal.  But I think $40 a month is extortionate!  I've never had blood drawn at my neph's office; I always go to the lab and the nice Polish lady always takes my sample.

It will be sorted out somehow, but I don't know if my insurance company will agree to cover it.  I may end up still having to pay out of pocket.  It does seem odd that no one else has this problem.  Insurance rules sure do have this patchwork quality about them.

[MooseMom]

An interesting thing happened to me yesterday.  I went to the lab to have my monthly GOH blood draw, and this time, two phlebotomists were on duty, both of whom I have seen plenty of times.  I signed it, and when it was my turn, I went to the front desk with my box and was prepared to pay the $40, since this was a "non-neph" blood draw month.  The Polish phlebotomist started telling the other lady that I was to pay for the draw, and the other lady kept rabbiting on about my paperwork.  Well, I have no paperwork, and the Polish lady was trying to explain this.  The other lady finally said, "I don't have time to fool around with this," and she ushered me back.  I sat down, and she said, "This is for a transplant, right?  This is your LIFE we're talking about...you shouldn't have to be paying for this.  The next time you come, don't sign in...just come on back."

I was rather bowled over and thanked her profusely.  I honestly don't remember the last time that someone did something nice for me just because it was the right thing to do.

[cariad]

That's a great story, MM! I am delighted for you.

There is humanity (and perhaps a dash of common sense) left in the medical world after all! Who knew?

[Marina]

I  get  my  vial  in a  styrofoam  case,  a  label  and  and  a prepaid  box  to send it  back  to  the  TX  center.
I  get my  blood  draw  every  month,  so   I  just  bring my  tube  in  as  well.  They've  never  mentioned  anything  about  a co-pay,  although  my  HMO pays  100%  for  blood  draw  (as  long  as  I  go to  an  approved  lab).  Who  knows  maybe the labs  bills  my  insurance  for  an  extra  vial.