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Old 08-03-2012, 09:15 AM #1
StephC StephC is offline
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Default Musk test worth $2500 out of pocket?

I have tested negative for MG antibodies and the EMG was negative but 2 doses of 60 mg Mestinon helped lots! Anyway, my insurance is giving me hard time about covering the Musk test. Since you can test negative for Musk and still have MG why pay $2500 (on top of monthly insurance premium of $1200.00)? Why not just use mestonin if it is helping? Am I missing something?

Thanks for any insight and advice.
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Old 08-03-2012, 10:52 AM #2
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I wouldn't spend the money myself. Mine was negative. Everything is negative. My neurologist still says that I have MG.
The insurance will probably pay for the test eventually if they keep asking. I would be sure that they pre-approve it though.
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Old 08-03-2012, 11:15 AM #3
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No, I would not pay for it. However, please note that MuSK MG ordinarily does not respond as well to mestinon so if you're getting almost complete resolution of symptoms with the use of mestinon, you very well may have a different antibody causing the problem. It could still be MG, however.

If you can get into a neuro who works in an MDA clinic, your worries of copays and uncovered stuff will be resolved. MDA pays for all of my office visits--even the copay! They paid for my test.

Keep hanging in there!
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Old 08-03-2012, 01:13 PM #4
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Steph, before you make a decision, ask the lab if they'll give you a self-pay discount. Labs have two different prices for the tests they do: the official price, and the price they've contracted with the insurance company to pay. If you ask, they might give you the contracted price instead, which can be a fraction of the official price.

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Old 08-03-2012, 02:05 PM #5
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Steph,
I'm not sure if this will help you or not, but Athena, the lab that does the MUSK testing has a patient protection plan. I used it when I had the MUSK testing done. It significantly limited the cost I incurred for the testing. My insurance plan did not contract with Athena.

I'll try to post the link here, but if it doesn't come through just google Athena and patient protection plan. Hope this helps.
http://www.accessathena.com/patient-...tion/index.jsp

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Old 08-05-2012, 01:09 AM #6
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I called Athena directly to ask about the cost of the test, since I couldn't get a straight answer from my insurance on whether they would pay or not. They told me the test was $1300 if the insurance didn't pay. However, if I paid myself, up front, without even trying to run it through the insurance, it would only be $800-something (I forget exact numbers).

I looked up their phone number on the internet. Got the test code from their website since my doc's office didn't bother look it up for me. (which is why I couldn't get an answer on whether they'd pay, doc's offices wouldn't be bothered to deal with my insurance co, and as a patient, all I can get out of them is the standard "IF it's medically necessary..." which I have learned means absolutely NOTHING.)

So you can look into it yourself, and find a better deal on the price. Don't know where you got the $2500 figure (someone padding the bill?), but the lab itself gave me the lower numbers above just 2-3 months ago.

good luck.
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