Originally Posted by squirrly
After a complete check-up, my internist wanted me to have a bone density done. I had told him that the rheumatologist's office had done a "Dexa Scan" in his office last year. I checked into the radiology dept., and the first question from the tech was "Have you had a bone density before?" When I said yes, she warned my that Medicare might not pay the $200 for this test, since it had not been longer than 2 years ago. We called Medicare and of course it was "Medicare covers a bone density once every 24 months, unless medically necessary for one sooner". Needless to say, I left without having it done. I am so grateful for that intelligent tech! I think all doctors should be aware of that rule and tell the patient. Has anyone on this board had to pay for the test out of pocket?? Squirrly
Hi Suirrly: I have yet to meet a doc that didn't know about the 24 mo rule on dexa scans, so I've never had that problem with such a lack of knowledge. If you go through your medicare handbook, you can figure out what the time limits are on all med procedures. In my case I had a second scan done in 12 months, but I didn't have to pay for it because the doc wrote a letter saying that it was medically necessary. I'm glad the tech caught it, in your case, but there really is 'no excuse' for a doc not knowing this, since the vast majority of them deal with medicare on a daily basis. If you thoroughly read the handbook, this type of thing should never happen again, because YOU will know what the rule is and not have to rely on docs that, in your case, sound very uninformed. Really sorry this happened to you! But you can prevent it from happening again by reading the book, even though I know how confusing that medicare handbook can be
I've always believe they must have hired someone to write that book to make it purposely confusing, when that isn't necessary. Once you get used to reading it it will seem less confusing and you'll know all the rules like how often you can get mamo's, pap, chest x-rays, blood transfusions, lab test's etc, etc. You can also call 1800 Medicare and they will explain any questions you have. Never make the mistake that "all" docs know more than you do, after
read that handbook, you'll have the upper hand. Per your question about paying for it out of pocket, I considered it and would have, if it hadn't been deemed medically necessary by medicare; but the price I was quoted was about $75.00 cheaper than yours, but that price would depend on each individual lab. In my case it was crucial to find out if I needed to go on Forteo, and I couldn't wait another year while my t-score plummeted.
Good Luck, and I sure hope this doesn't happen again. Read, Read, Read