Antibody testing & Insurance

[LuvOrlando]

So what's the deal with testing and insurance? Anyone have experience? We are in PA right now, I contacted my family Dr about testing in email & was directed to Quest and on their website they directed me to my Dr because it could be covered by INS if it goes through the Dr. Called BCBS to see what they say and of course, no-one is there. Is this a hot potato thing? Wondering if Drs being discouraged from authorizing testing? This seems unfair to the poor who can't afford to pay OOP so I'm going to circle back on Monday because I am hoping we are not all just supposed to fend for ourselves

 

[LuvOrlando]

A month later and answering my own question in case another person does a search:
Had one at Labcorp the other day and they used Abbott 164057-sars-cov-2- igg assay,
Dr was able to see the brand on the results page
Went through insurance, PPO Capital Blue & they said it's covered with a Dr prescription as medically necessary but not for screening purposes, which I guess means without a reason or to just do it yourself.

I guess this is a Community service message

 

[disneychrista]

Seems crazy to me that this would be covered as “medically necessary” when there really isn’t any benefit to it. The tests aren’t accurate and knowing you had it at some unknown point isn’t really beneficial if there are no guarantees the antibodies give you any type of protection.

 

[LuvOrlando]

After 17 days this looks pretty useful, I suppose you could find a Dr to debate but I think mine is a smart human.

"New research from the University of Washington, published in the Journal of Clinical Microbiology, found our SARS-CoV-2 IgG assay had 99.9% specificity and 100% sensitivity for detecting the IgG antibody in people 17 days after symptoms began"

https://www.corelaboratory.abbott/us/en/offerings/segments/infectious-disease/sars-cov-2

 

[tvguy]

Seems crazy to me that this would be covered as “medically necessary” when there really isn’t any benefit to it. The tests aren’t accurate and knowing you had it at some unknown point isn’t really beneficial if there are no guarantees the antibodies give you any type of protection.

Well everything I can find says it is required by be covered by insurance and if not the government will pay for it. There is a HUGE benefit in tracking the benefit.

 

[ohiomom28]

I don't see why antibody testing would be covered by insurance as it doesn't tell you anything except whether you had it or not in the past. The Covid swab itself, I can see being covered.

 

[disneychrista]

Well everything I can find says it is required by be covered by insurance and if not the government will pay for it. There is a HUGE benefit in tracking the benefit.

I understand that is it required to be covered. Doesn't it make it any less crazy to me. Our insurance rates are sky high all ready. This whole mess (Covid in general not specifically the antibody testing) is going to make it even worse.

There is some benefit is to RESEARCHES but not to the individual.

 

[Imzadi]

This seems unfair to the poor who can't afford to pay OOP so I'm going to circle back on Monday because I am hoping we are not all just supposed to fend for ourselves

NY state is a "scientific fact and data" based state. As such, from Day 1 & Day 2, when we had the first 2 known cases on the east coast, our state's Dept of Health as well as NY City's Dept of Health have believed it is necessary to collect the number of positive COVID-19 as well as the positive antibody numbers, as it helps them establish what is happening in our state. So, we are lucky to have state funding focused on providing free COVID-19 testing as well as antibody testing. (Everybody, check your own state's Dept of Health to see if they offer free testing.)

The Commissioner of the NYS Dept of Health worked closely with Abbott Architect to create the two tests for accuracy, which are now being used by NYS and Abbott (and approved by the FDA,) at the free testing sites.

Antibody tests help to determine where the spread of COVID has been. Especially in the people who were never sick enough to have to go to the hospitals, as well as the potential number of asymptomatic people out there. (Dr. Redfield, director of the CDC, said just a couple days ago at the Congressional Hearing, that he estimates that there are currently up to 10 times the number of unknown cases, over the known, tested COVID cases logged.) It also helps determine how close we are to "herd immunity" IF there actually will be such a thing for COVID-19. NYC became the epicenter of the U.S., then the world, with the most cases. (Until Brazil recently took over that moniker.) Yet, we are currently only at about 26% of the population of NYC is positive for antibodies. It is estimated that there needs to be about 70% to get to herd immunity.

I supposed, IF it is determined that we do have herd immunity, that is important for the insurance companies to know. Down the line, they won't have so many COVID-19 patients to pay for. There are some patients who've been on ventilators for 30-60 days. One man here was on a ventilator close to 60 days and recovered. Then he was sent his medical bill, with the hospital stay and all the various treatments he had needed. The bill was over $1.1 million dollars. Luckily, his medical insurance will cover the majority of those charges.

I also think an insurance company would want to have their own research on how many of their own clients have antibodies, what are the demographics and comorbidities that lived through it. They won't get that info from the general antibody test study results put out by states and other entities.

 

[tvguy]

I understand that is it required to be covered. Doesn't it make it any less crazy to me. Our insurance rates are sky high all ready. This whole mess (Covid in general not specifically the antibody testing) is going to make it even worse.

There is some benefit is to RESEARCHES but not to the individual.

Why would people finding out they have the coronavirus so they can quarantine and not spread it to others be crazy?

 

[LuvOrlando]

I think there is an assumption that health insurance rates are going to go up by testing, which is not really reasonable if illness is producing million dollar medical bills or if people die and leave the bills unpaid. I sort of suspect it's in everyone's best interest that this thing be tracked as closely as possible so that maybe communities can get out in front of it to prevent widespread losses of every sort. Easier to close bars in town X a week and track down a few spreaders then a whole state

Wasn't not being quick enough on the draw what made this happen in the first place? Wouldn't perfecting community tracking be to the benefit of all? Yes, this helps researchers but they are trying to save us so isn't that a good thing? If I'm a puzzle piece then good,

 

[ohiomom28]

Why would people finding out they have the coronavirus so they can quarantine and not spread it to others be crazy?

The antibody test tells you if you've had it in the past, not currently. The Covid nasal swab is to test if you currently have it.

 

[tvguy]

The antibody test tells you if you've had it in the past, not currently. The Covid nasal swab is to test if you currently have it.

But both are helpful, may save a life, and free.

 

[LuvOrlando]

The antibody test tells you if you've had it in the past, not currently. The Covid nasal swab is to test if you currently have it.

The antibody test is a blood test and the labs are posting the difference just about everywhere. All over the Labcorp appointment page, on every phone call, posted outside the lab & inside the lab and during the process nevrmind getting it by my Dr who needed to write the script anyway. The labs here that do antibody DON'T do active disease with symptoms, and the tech asks outright. The active disease one is the swap and from what I've heard that's equally hard to miss if you go to even CVS etc.

A person would need to absolutely incapable of communication to get them mixed up

 

[disneychrista]

Why would people finding out they have the coronavirus so they can quarantine and not spread it to others be crazy?

What would be the point of quarantining if you had the disease in March? Knowing you had it doesn’t change anything.

 

[hopemax]

Seems crazy to me that this would be covered as “medically necessary” when there really isn’t any benefit to it. The tests aren’t accurate and knowing you had it at some unknown point isn’t really beneficial if there are no guarantees the antibodies give you any type of protection.

A medical benefit of knowing you have had it, is if there are long lasting side effects. If you go to your doctor 6 months or a year from now, or even 20 years from now, complaining of things that could be pulmonary, cardiac, vascular and there is a note that said you tested positive for COVID in 2020, then your doctor might be able to provide a better/quicker diagnosis by having that evidence. If antibodies aren't long lasting, then in the future we won't be able to go back and answer the question, "could this be COVID related?" Leaving it up to the doctor to decide if they should presume you did/didn't have it, and potentially going down the wrong path for a time. If you are positive, even if it was a false positive, there is a place to start and work from there.

EDIT: I'm also thinking about this specifically for people who already have various medical conditions. Since we don't know what will be aggravated by COVID, doctors might need to ask, is this the condition, is this covid, is this condition+covid?

 

[missnic]

BCBS (Florida) covers antibody testing if a Dr. orders it.

 

[muffyn]

Right now if you donate blood to the red cross they give you an antibody test for FREE!

 

[tvguy]

What would be the point of quarantining if you had the disease in March? Knowing you had it doesn’t change anything.

Well, the test doesn't tell you when you had it, and the blood test showing anti-bodies would prompt me to get the nose swab test to see if I currently had it because apparently they are finding that despite the anti-bodies, people are getting reinfected. One person has had covid-19 three times.

 

[Monykalyn]

What would be the point of quarantining if you had the disease in March? Knowing you had it doesn’t change anything.

yes it does. If you are capable of donating plasma and you have antibodies you could literally save someone’s life knowing that. My step daughter at Mayo is part of that trial. So there’s a HUGE LIFESAVING advantage. If a state or community knows how many active, recovered, and antibody positive cases there are it can also affect policy.
And it’s very likely there is at least SOME immunity - even if antibody isn’t positive. The immune system has different kinds of T-cells that will still mount a defense. In fact it’s now speculated that this is why only a percentage of the population is even susceptible to covid 19; and also why herd immunity may be much lower than previously thought -just read about a study/modeling that herd immunity could be as low as 43%.
The immunity memory is why the 2009 H1N1 flu was so much deadlier to young people and kids- because even though it was a novel strain people who lived through the 1968 flu (think it was that year) had a “memory” in their immune system and kept them from being seriously ill.

One person has had covid-19 three times.

no that’s been debunked. Now thought she had ongoing active infection whole time and the first test may even have been a false positive. Still an outlier.

 

[disneychrista]

Well, the test doesn't tell you when you had it, and the blood test showing anti-bodies would prompt me to get the nose swab test to see if I currently had it because apparently they are finding that despite the anti-bodies, people are getting reinfected. One person has had covid-19 three times.

If I wanted to know if I had it I wouldn't start with an antibody test I would start with the actual COVID test. Visit an OptumServe site, get tested (for free) as often as you like.

As to the bold - this is why getting the antibody test doesn't mean much (in my opinion). Having the antibodies might tell you that you had it at some point but it doesn't really mean anything if having the antibodies doesn't provide any protection.