Cigna insurance did not cover my lab tests

Hello,

Apologies if this is long. I wanted to share all the details. I appreciate any insight or help I can get.

I just received a $533 bill for lab work I had done at the beginning of the month. I have Cigna Choice Plus PPO (Open Access.) I had made an appointment with a PA, as I had some concerning symptoms and was afraid I was diabetic and had general health concerns. It had also been a few years since seeing a doctor (so it was my first appointment with this clinic.) Once speaking with the PA about my symptoms and establishing care, she ordered labs to be completed. Multiple blood panels.

These were the labs as shown in my results: AC1, WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, plt, MPV, neut%, lymph%, mono%, eos%, baso%, lg%, NRBC%, neut#, lymph#, mono#, eos#, baso#, lg#, glu, BUN, crea, GFR, GFR afric, BUN/crea, Na, K, cL, CO2, Ca, TP, alb, glob, A/G, tbil, ALKP, AST, ALT, FSH, LH, ins, prol2, TSH, vitd, E2, prog, chol, HDL, trig, LDLC, chol/HDL, VLDL, HCV, 17-hydrox., anti-mullerian hormone (amh), testosterone

On my bill in my provider's portal, I see nine services listed. It seems as though there was a small "Insurance discount" applied to each aside from the "General Health Panel", but the majority of the lab costs were not covered (total cost was a bit over $700 before discounts.) This is what I see: Hemoglobin glycosylated a1c, Estradiol assay, Gonadotropin follicle stimulating hormone, Insulin total assay, Prolactin assay, Lipid panel, Progesterone, Gonadotropin luteinizing hormone, General health panel

Looking at my plan details, I am confused on my coverage. According to my plan summary, laboratory services for the Physicians services/office visits should be 100% covered without deductible or co-insurance, as well as independent labs and outpatient facility labs. I don't think it would fall under this, but preventative care including preventative labs should also be fully covered in network. However, looking at my Cigna portal, they seem to be treating 10/11 line items as not covered (but with discounts applied) and have said my payment of the bill will go towards my in-network deductible. In the bill, I do not see a breakdown of the types of labs either, just 11 line items titled "Laboratory."

Any help would be greatly appreciated. I have not done anything about this yet, as I wanted advice first.

submitted by /u/brir_b
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