Insurance Coverage FAQ

Can I use my HSA/FSA account to pay for a test?

Generally speaking, yes, you can use your HSA/FSA account to pay for an at-home health test. Your EverlyWell test is authorized by a physician, so it fits the guidelines for most HSA/FSA coverage. If you have a particularly rigorous plan, it is best to check with your own plan if you’d like to verify before purchase.

How does your pricing compare to insurance?

Generally, EverlyWell’s tests are priced lower than out-of-pocket costs, and are usually the similar or lower than insurance coverage. However, as with all healthcare-related expenses, this can vary based on your own personal insurance plan, if you’ve met your deductible or not, and which test you’re ordering.

For this reason, it’s difficult to provide exact information about each customer’s specific insurance reimbursement. Insurance companies may cover a portion of our tests.  While we provide a receipt, we can not guarantee any insurance reimbursement.

How does your pricing compare to medicaid?

For certain diagnostic tests, medicaid will cover the cost of that test. In this case, the pricing if covered by insurance would of course be lower if completely covered by Medicaid.

However, Medicaid often does not cover health tests like these, and in these cases our prices are typically lower than out-of-pocket costs for similar tests taken within an office environment.


How can I find out if I have insurance coverage on your tests?

Due to the vast variety of insurance policies, companies, etc., the best way to determine whether or not a test is covered by your insurance provider is to contact them directly and discuss coverage. This is great advice for all medical procedures, as many consumers are hit with unexpected bills months after receiving care. With EverlyWell, you know the exact price, with no hidden fees or mystery bills.

Typically our test pricing is comparable to the out-of-pocket costs of testing in a clinical setting. Additionally, there is a chance that any test may be covered partially by insurance but in many cases, at-home tests are not covered by insurance.

There are, however, certain tests that are more likely to be covered than others. If you’re ordering one of the following three tests, you could consider contacting your insurance carrier for more information:

  • Cholesterol & Lipids Test [More Below]
  • Comprehensive Thyroid Test [More Below]
  • Inflammation & Vitamin D Test [More Below]

 

Click on the links above to learn more about what to ask your insurance provider in discussing coverage for these tests.


Discussing Coverage: Cholesterol and Lipids Test

The Cholesterol and Lipids Test is one of the more frequently covered at-home tests for insurance carriers. To determine whether your carrier will cover all or a portion of the cost of EverlyWell’s at-home cholesterol test, please contact them directly.

When discussing coverage, it is important that your carrier understands specifically what the test is and what it is testing for. Be sure to mention the following key points:

  • The test is taken at-home via a blood sample and analyzed by our partner laboratories
  • The test measures:
  • Total Cholesterol
  • HDL
  • LDL
  • Triglycerides
  • Direct-LDL
  • hs-CRP
  • HbA1c
  • The report measures the above markers and reports on whether they are high, low, or within the normal healthy range.

Here is the contact phone number for the top major insurance companies. If your carrier is not listed below, they still may cover! Contact them and discuss the information outlined above.

  • Humana -  (800) 833-6917
  • Aetna - (800) 872-3862
  • United Healthcare - (866) 633-2446
  • Cigna - (800) 997-1654
  • CMS (Medicare / Medicaid) - (877) 267-2323

Discussing Coverage: Comprehensive Thyroid Test

Note: This is specific to our new Comprehensive Thyroid Test and not related to our standard Thyroid & Metabolism Test. Be sure to understand which you are seeking coverage for as the Comprehensive Thyroid Test (discussed here) is the more commonly covered.

In many cases, our Comprehensive Thyroid Test will be eligible for some amount of coverage by insurance providers. As always, this will depend on your own coverage but we encourage you to check with your insurance company to see whether they will cover all or some of the cost of our at-home thyroid test.

When discussing coverage, it is important that your carrier understands specifically what the test is and what it is testing for. Be sure to mention the following key points: 

  • The test is taken at-home via a blood sample and analyzed by our partner laboratories
  • The test measures:
  • TSH
  • Free T3
  • Free T4
  • Anti-TPO Antibodies
  • The report measures the above markers and reports on whether they are high, low, or within the normal healthy range.

Here is the contact phone number for the top major insurance companies. If your carrier is not listed below, they still may cover! Contact them and discuss the information outlined above.

  • Humana -  (800) 833-6917
  • Aetna - (800) 872-3862
  • United Healthcare - (866) 633-2446
  • Cigna - (800) 997-1654
  • CMS (Medicare / Medicaid) - (877) 267-2323

 

Discussing Coverage: Inflammation & Vitamin D Test

We’ve seen our Inflammation & Vitamin D test get covered to some degree by various insurance plans and yours may be covered as well. To check on whether your own insurance carrier will cover all or some of the cost of our at-home Inflammation & Vitamin D test, please contact your insurance company directly to discuss.

When discussing coverage, it is important that your carrier understands specifically what the test is and what it is testing for. Be sure to mention the following key points:

  • The test is taken at-home via a blood sample and analyzed by our partner laboratories
  • The test measures:
  • hs-CRP (a commonly tested marker for inflammation)
  • Vitamin D levels
  • The report measures the above markers and reports on whether they are high, low, or within the normal healthy range.

Here is the contact phone number for the top major insurance companies. If your carrier is not listed below, they still may cover! Contact them and discuss the information outlined above.

  • Humana -  (800) 833-6917
  • Aetna - (800) 872-3862
  • United Healthcare - (866) 633-2446
  • Cigna - (800) 997-1654
  • CMS (Medicare / Medicaid) - (877) 267-2323

  

Can you check on my insurance for me?

Unfortunately we can not handle checking on insurance coverage for tests on a case-by-case basis. Your own coverage is unique to you and it is best that you reach out to your insurance carrier directly if you’d like to learn more about your options.

Below you will find contact information for some of the top major insurance companies. If yours is not listed, you still may have coverage and we encourage you to contact them directly to learn more.

  • Humana -  (800) 833-6917
  • Aetna - (800) 872-3862
  • United Healthcare - (866) 633-2446
  • Cigna - (800) 997-1654
  • CMS (Medicare / Medicaid) - (877) 267-2323

What are typical lab costs and how transparent is lab pricing normally?

For traditional tests (doctor ordered and taken within a clinic or lab) lab pricing is typically very complicated and not transparent for the consumer. The pricing will vary (sometimes dramatically) by laboratory, institution, test type and markers checked, your personal insurance coverage, and more. Clear communication of pricing like EverlyWell’s is quite rare within testing and we can’t speak to what your own tests within a lab environment may end up costing out of pocket.

 

Are there online tools or apps that I can use to check for my coverage for any one test?

Not that we’re aware of but we’d love to learn about one if you find it! Most tools for checking insurance coverage are insurance-operated and apply specifically to physician-ordered tests. As mentioned above, the absolute best way to check on your own coverage is to call or email your insurance company directly to discuss your personal options briefly. We cover a few of the more commonly covered tests (and what to mention) above.

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