A few weeks ago while at my yearly cardiologist visit, my doc says, “Hey, there’s this fairly new test called a T-Wave Alternans Test that can tell if you’re prone to dropping dead while jogging. I’m gonna have you take it.” So I figure, okay – it would be a good thing to know if I’m gonna die while jogging. Let’s go.

The test is relatively painless – you walk on a treadmill with electrodes — you’re not even running. The prep kinda sucks though because they actually scrape you down with something I would describe as medical sandpaper. They actually use two different grit strengths and it basically leaves a bunch of little raw spots on your chest, sides, etc. It especially hurts when they rip the electrodes off the raw parts at the end of the test. Anyhoo, the test turned out fine. I’m not gonna die… from that anyway.

Flash forward to yesterday when I get a letter from my insurer, United Healthcare (UHC) saying they won’t pay for the $1,050 test. Technically they said:

“Based on the information probided, this service is unproven and is not covered. Therefore, no benefits are payable for this expense. In order for this service to be considered for coverage, you must submit scientific evidence, that meets the standards described in your benefit plan language, that demonstrates the safety and effectiveness of this service for your particular condition.”

Blech. Here’s a lesson to all of you, make sure you find out from your insurance company whether they’ll cover a procedure before you let your doctor perform it. My mistake was that I’ve never had any issue with any insurance company for tests or procedures, so I didn’t check in beforehand. My doctor’s mistake was that he didn’t double-check either. I’d say we’re both at fault. Plus, insurance companies are fairly evil, but they’re not as bad as not having any coverage.

So, I called the insurance company for more info, and the best they could do was read me the passage I outlined above. Great… I called my doctor’s office and a day later their billing department called back. I faxed them the forms. An hour later they called back and said pretty much the same thing the insurance company said – UHC won’t pay. But she said that they’d be willing to drop the price on the procedure to $200 (from $1050) if I’d be willing to pay.

Ugh. This might have been the wrong decision, but I agreed. I’ve heard such horror stories about fighting claims, that I gave in. I probably should’ve hung in there and tried to get them to eat the entire cost since they didn’t pre-certify me, but at the same time it was my own damn fault for not checking it out myself. If my doc had told me up front that “There’s this test that not all insurance companies are willing to pay for but I think it’s important you get it,” then maybe I would’ve been down with fronting part, if not all of the cost.

At least I’ll get points on my card.