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Insurance denied MRI, now what?

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Old 09-15-2003, 06:49 AM   #1
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Location: Virginia,USA
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khorne HB User
Question Insurance denied MRI, now what?

I went to my Dr. with all of my symptoms & told her I wanted to have the blood test to test for MS. She told me that no lab in our area will process the blood test so I would have to have an MRI. It's scheduled for next Mon. & now my insurance won't approve it, wth? What do they expect me to do? Live like this forever, this everyday worry about what the hell's wrong with me? Sorry to rant, but I was wondering if any of you have had the same problem & what you did about it. Thanks! K.

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Old 09-15-2003, 09:14 AM   #2
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Mom_of_two HB User

I am wondering why your insurance denied paying for the MRI? Wasn't it per your doctor's request? Is this doctor a neurologist? Does he/she agree that your symptoms sound as if you "might" possibly have MS? If so, then I don't see why the insurance isn't covering the MRI. Maybe you should get a second opinion, and then that doctor can tell your insurance that it's vital you find out this info with an MRI, therefore they'd more than likely pay for it?!?! If I may ask, what kind of medical insurance do you have?

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Old 09-15-2003, 10:13 AM   #3
always wondering
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always wondering HB User

Hi! I'm no expert, but maybe the insurance will approve a spinal tap. I'm convinced I have MS (but what do I know, I'm not a doctor). I've had 2 MRI's that have come back fine, but I've heard of cases where MS has been diagnosed with a spinal tap and clean MRI's. Maybe your doctor will be willing to go that route. Sorry about the insurance company's - seems as if we're always getting the raw end of the deal. Good luck!!


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Old 09-15-2003, 12:14 PM   #4
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I found out today that they approved a CT scan, so I'm having that done on Thursday. Do any of you know if that's a "good enough" test to test for MS? I'm not doing a spinal tap, that sounds like torture! I'm terrified enough as it is with the scan. My insurance co. wants to explore other avenues before they'll approve an MRI. My pcp requested it, I don't have a neurologist, yet. That'll probably be the next "step" in the process. My insurance is Health Keepers, they can be a pain in the butt sometimes, but it's affordable, if you know what I mean. Wish me luck on Thurs. I'm about to go out of my mind with worry!!!

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Old 09-15-2003, 10:39 PM   #5
Join Date: Sep 2003
Location: San Antonio, TX, USA
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LillyDee HB User

Hey KHorne! I was diagnosed with MS about a month ago. The Docs. weren't sure what was going on with me at first. I had a CT Scan, but it didn't show anything. I had to get the MRI done...that's when they saw the lesions on my cervical spine. I just had an MRI of my brain because the doc was pretty sure I have lesions on my brain. You may need to find an advocate in your area so they can convince your insurance co. that you need the MRI to properly diagnose you. You also should be your own advocate, it's your health and you have to take care of yourself because if you don't...who else will? Good luck!!

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Old 09-15-2003, 11:03 PM   #6
Join Date: Jun 2003
Location: Edmond, OK, USA
Posts: 63
catstrack HB User

Hi K --

Sorry to hear you're having insurance problems. My family doctor approved my MRI before he referred me back to the neuro I'd seen several years ago....after FD got the results, so any doctor can.

Insurance companies can be funky about wanting to pay for some things and a CT Scan is going to be less for them than an MRI (mine was around $2500.00).

It could be just be a process of elimination for them as to where to go (pay) for the next step, but I'd say go ahead and have the CT scan. If it comes back negative then press for the MRI even if you need to put in a complaint to your state's insurance commissioner board.

Also, your doctor needs to advocate for you, in principle. If she doesn't then call the state Medical Board and report her.

Best wishes. We'll be thinking of you. Let us know what happens. God Bless. Sherry

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Old 09-16-2003, 05:36 AM   #7
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khorne HB User

Thank you, thank you, thank you!!! You guys are so incredibly sweet & caring, I really appreciate it!
My test is Thurs. so I'm not sure how long the results will take to get back to me, I'll probably have to wait through the weekend. I'll let you know. Please send good vibes!

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