Tricare Won't Pay For My Enterolab Work

[Sarah8793]

They denied the claim even though I sent a letter from my GI doctor requesting/approving the tests and a coded invoice. UGGGHHH! Tricare said that EnteroLab is not certified with them. I told them at Tricare that EnteroLab is an independent lab and that they don't certify with any insurance companies. Didn't matter. I remember reading of others on here getting Tricare to pay for theirs, but I guess they must have had their doctor's lab order from EnteroLab. My doctor has moved to a new office and said he doesn't have his own lab. Huh??? Live and learn I guess. $500+ hurts a little, but it was definitely worth doing.

Sarah

[AndreaB]

I'm sorry you got the run around Sarah.

We got enterolab tests done too...I didn't even bother with finding out if insurance would cover it. I too agree that it was worth the expense.

[gf4life]

My insurance won't cover ANY test not ordered by a doctor and they only cover tests ordered by the doctor if it is done by certain labs/hospitals. So I didn't even try to get my insurance to cover it. I figured if they won't pay for an MRI that both my GP and Neurologist think I should have, then they aren't going to pay for a test by a private lab that i ordered for myself...

That said I do believe it was money well spent and I would do it again in a heartbeat if I had to. And for us it was closer to $1600 since we had 4 out of 5 in the family tested. Still cheaper than if we had the kids tested at Prometheus for $2700 (which also would not have shown my boys gluten intolerance genes) and my insurance wouldn't pay for that lab either.

[penguin]

Has anyone tried with United?

[tarnalberry]

Don't forget that just because an insurance company has paid for a test for someone else means that *your plan* through that came company will cover that test/procedure. Almost all insurance companies offer a wide range of plans, and what they will cover varies greatly between the plans, regardless of the fact that it is the same parent company.

[Lymetoo]

Has ANYBODY gotten theirs covered by insurance?

[Turtle]

Okay, i'm gonna sound REALLY dumb i'm sure but can someone please explain to me what these enterolab tests are? I keep seeing threads about them but don't have a clue what they are, what they look for, why you would have them done, do you have to ask for them to be done or does your dr suggest them etc. Thanks in advance!

[AndreaB]

Turtle,

The are an independent lab that tests stool for gluten antibodies as well as ttg, malabsorption, gene test and they also do dairy, soy, egg and yeast. www.enterolab.com if you want to check them out. We did the tests on our own. Most people do I believe. They are more sensitive than blood work because the antibodies start in the intestines and once they reach a certain level are traceable in the blood. I like them because they can catch the disease in it's early stages thus minimizing the liklihood of further diseases/illnesses because of further damage.

[Sarah8793]

Well looks like it is more the norm to not get insurance coverage for it. I'll pay again when I need to test my children. Thanks for sharing.

Sarah

[Turtle]

Thanks AndreaB!

I'll check out the website!