Lupus Testing on a Budget

It's been very expensive on my end to maintain my "I think you might have an autoimmune disease but we're not sure" lifestyle.  I bet I have spent, over the last nine years, close to ten grand for various tests, ER visits, antibiotics, and whatnot, and I had super-duper government insurance for four years of that.  And none of that spending was my idea.  It's rather frustrating to imagine what my new car would have looked like had I been a normal, healthy person. 

It wasn't too bad when I had the federal government paying for all my medical insurance as the dependent of a military officer.  It really sucked when I was paying $400 a month out of pocket every month for my insurance when my hubby was working as an engineer.  As a student...?  Meh.  It's a compromise.  Some things work well, and some things don't.

On the one hand, my student insurance drags its feet, kicking and screaming, every time I have a big budget expense like my gall bladder surgery.  I have to prove I'm still a student by sending in a form to the registrar which somehow never quite makes it by the deadline and my claim gets rejected.  Then I get to scream at them (which is quite exhilirating.)  But I've never had to eat a single claim.  It's all worked out. 

On the flip side, I've discovered a few benefits to being tested for an autoimmune disease on student insurance that might not be available to the common insured.  I shopped around until I found my wonderful student clinic doctor, Dr. H., and I've stuck with her for practically everything over the last four school years.  She's gotten to know me (and my prodigious medical chart) and has a good feel for what things I actually need to stay healthy and which tests and procedures are just extras.   And, since she works with students a lot, she's very sensitive to the cost issue.  She doesn't short-change my health care at all, but she has some nice ninja-esque tricks to keep the costs down on my end. 

For instance: at my university, we have a fully-functioning health clinic with a lab, which means that they can do a surprising number of blood, urine, fecal, and skin tests in-house.  The way my insurance works is that anything that doesn't need to be sent out to be processed I get done for free.  They give the doctors a lot of warnings about running needless tests to keep costs down, but I can still get a lot of my bloodwork done without paying anything out of pocket.

So, here's the arrangement me and my doctor have been using.  We built up a nice little schedule of regular testing (about every eighteen months) for the autoimmune stuff, and she stuck mainly to the cheaper tests that can raise red flags and indicate a need to test for other stuff.  For instance, I get tested for syphilis to see if I get a false positive result.  (I think our campus gets a wholesale rate on STD testing kits or something.  Go figure.)

Whenever other red flags raised up (like my funny liver test,) she ran more specific testing in-house.

Whenever she's sent me to some kind of specialist (like the rheumatologist coming up) she anticipates the blood tests she's pretty sure that the specialist is going to order anyhow, and she runs them up front and sends them along with my chart.  That way the specialist gets their tests ahead of time and I don't have to pay for them.  Nifty, huh?   The especially nice thing is that, so far, her forward-thinking has saved me a followup visit or two as well.  That's pretty sweet when you consider my copay for a single visit is a hundred and fifty bucks. 

So far, I've only had one test that the student health service couldn't run themselves-- celiac disease.  But it was still cheaper because the university lab could draw the blood, and I didn't have to pay a copay to have someone else do it.

For other tests, like ultrasounds and whatnot, I never leave the doctor's office without a referral, whether I need one or not.  That cuts out any possibility of the insurance denying a claim based on not having a referral ready.  

And so, that's one way I've started to figure out how to do lupus testing on a student budget.