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Blood test for every refill on thyroid meds?
Old 11-18-2019, 08:25 PM   #1
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Blood test for every refill on thyroid meds?

DW has been on thyroid medication (fairly low dose) for about five years now. Recently, her doc has been requiring a new blood test each time she needs the prescription refilled. Now I get that to a point, but if the numbers have been fairly stable, and it's $220 every time they draw blood for a refill.....


... I guess the question is, is that standard operating procedure here? If it is, we'll deal with it -- it's not going to break us or cause a lifestyle change -- but if it's not typical I'm wondering if we can use one of those $30 virtual doctor visits to get someone to refill it, or find another doc to do it.

The funny thing is that the medication is about $4.40 per month, or approximately nothing compared to the blood test to refill it.

Again, I understand and appreciate wanting to check this every so often, and certainly with each full blood panel done, but with each refill, when combined with fairly steady numbers, seems excessive to me. But what do I know?
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Old 11-18-2019, 08:33 PM   #2
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As in every year, or like every month or 90 days?

A lot of times it’s the insurance company/Medicare butting their nose into your physician’s practice pattern. They’re looking out for you (as in trying to justify not paying for your expensive prescription). I’d share your concern with your doctor and ask why he thinks the frequency of testing is necessary. But if your insurance requires it, he’s not going to budge.
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Old 11-18-2019, 09:00 PM   #3
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I have to get blood tests once a year. More than that seems unnecessary unless there is some sign of a problem. I been on meds about 40 years. . . . i think it is some legal thing doctors have to "check on you" every so often or can't renew.
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Old 11-18-2019, 09:29 PM   #4
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Originally Posted by Jerry1 View Post
As in every year, or like every month or 90 days?

A lot of times it’s the insurance company/Medicare butting their nose into your physician’s practice pattern. They’re looking out for you (as in trying to justify not paying for your expensive prescription). I’d share your concern with your doctor and ask why he thinks the frequency of testing is necessary. But if your insurance requires it, he’s not going to budge.

I think it's every 6 months.

As a practice it's good to get more comprehensive blood work from time to time anyway, but every 6 months seems like a lot given that the numbers have been pretty stable. If it's a hoop it's a hoop, and once a year I can start to understand.
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Old 11-18-2019, 09:39 PM   #5
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I have to have blood work annually for my Rx. What I discovered was that the doctor's office can do blood draw and send for labs for $X. Quest Diagnostic could do the same for half that amount. LabCorp could cut the Quest price in half. Since I have a high deductible plan, I would be paying 100%, so I went with LabCorp. You will need to have the code for the lab work to get quotes from the labs. And, of course, you need to drive to LabCorp for the draw, and ask them to send results to your doctor, then follow-up if the results are not sent right away. In my case it was 75% off the doctor office price, so the extra work was worth it. Good Luck.
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Old 11-18-2019, 09:44 PM   #6
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Seems expensive. Is there a cheaper place you can get it done? Maybe directly at the lab? I went directly to Lab Corp near me and it was super quick and easy, especially if I went near opening time in the morning. I had a TSH test along with a few other things. The TSH was priced at $43. All of the tests together were $499. After insurance adjustments, my total cost was $45. So the TSH was almost certainly under $10, maybe under $5. There is a base fee for any blood draw, but I had one specific test done once where my total was $7.
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Old 11-18-2019, 10:06 PM   #7
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OP, I feel your pain. My PCP was adding Vit D and Vit B12 levels to my blood work every 6 months because she was monitoring my abnormal lipid panel. With vitamin supplements, my levels were fine. Finally, I asked my PCP if monitoring my vitamin levels so often was really necessary. She stopped the every 6 month vitamin checks. I think that if you are on thyroid supplements but your levels have been stable, checking every 12 months should be sufficient. Can’t hurt to ask your PCP.
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Old 11-19-2019, 02:49 AM   #8
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Before using a lab, make sure they take your insurance. Otherwise they won’t be so cheap.
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Old 11-19-2019, 05:16 AM   #9
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If she hasn’t developed some comorbidity and it is standard hypothyroid therapy I think annually is usual if the dose has remained the same. So first I would ask. It might be insurance, it might be the organization in which the doctor practices. My pcp’s organization now has various things that get mandated and if I don’t get them done she gets dinged

Definitely also look at different labs. I have to have regular labs for a medicine too. Prescriber’s lab at Major medical center 55 dollars, quest near my house 18 and satellite draw station for a community hospital that is in the same system as my doctor 8 dollars
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Old 11-19-2019, 05:52 AM   #10
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If all they are measuring is TSH plus T3 and maybe T4, it should be much cheaper than that. Maybe $30.

How extensive is the panel?
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Old 11-19-2019, 05:52 AM   #11
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I have been on thyroid meds for many years, and I have averaged getting blood work every six months for my refills.
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Old 11-19-2019, 05:57 AM   #12
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I've taken l-thyroxine fo 25 years, at least. There were years when I had two TSH tests, but usually just one with normal blood work. May be time for a new doc.
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Old 11-19-2019, 06:02 AM   #13
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I had one doc send a Free T3 blood test to Quest, and after insurance adjustment (high deductible) I owed Quest $10.84.
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Old 11-19-2019, 06:19 AM   #14
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I get mine checked yearly, but it has been stable for 30 years now, so not changing at all. Doctors love to help their networks make more money by doing things like this.
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Old 11-19-2019, 08:08 AM   #15
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I too wonder where you are getting your labs done. My guess is your physician’s lab or a hospital lab. If the former, get a new dr. If the latter, as others have said, go to a regular reference lab.

Even a full thyroid panel should t be anywhere near that. For basic hypothyroid, once a year is typical. If you have a more complex condition (Comorbidities or hashimotos for eg) I can see asking for more frequent testing.
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Old 11-19-2019, 09:59 AM   #16
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I get my thyroid checked with every new prescription, which is annually.

I do not get lab work when I get my levothyroxine refilled, which is every 90 days.

Has there been some confusion between getting a new prescription and getting meds refilled? Every 90 days would be excessive imo.
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Old 11-19-2019, 10:27 AM   #17
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Just thinking in logical, general terms, it seems to me the issue is not about how long the readings have been stable, the issue would be how fast can the readings go bad to the point that there would be problems?

If the readings can go bad over the course of 3 months, and in another 3 months you might see problems that needed to be treated before they got to that point, testing every 6 months might be justified.

If it is something that gradually degrades over a period of a year, with no significant short term risks for months past that, then testing more often than annual seems unneeded.

I think you need to understand the risks of less frequent testing. Going on past history is a little like saying that I haven't checked my oil for 15,000 miles, and I haven't had any problems yet.

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Old 11-19-2019, 10:55 AM   #18
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If thyroid numbers change much, the patient will experience noticeable symptoms.
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Old 11-19-2019, 12:10 PM   #19
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I've had my thyroid tested annually for a long time for my prescription. I think I may have had a quarterly test right after I got my first prescription to make sure the amount was sufficient but annual has been in since then.

$220 seems crazy high for a thyroid test. I go to an Interpath lab they billed around $55 for a blood draw and TSH test. I didn't have to pay any out of pocket on my HDHP and my insurance only paid around $25 to Interpath. If you are paying for a doctors visit to get the blood draw maybe see if they can just send a test order to a test center like Interpath or Quest.
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Old 11-19-2019, 12:36 PM   #20
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For one month supply of levothyroxine, at Kroger, use insurance $8.00, use GoodRx (no insurance) $6.00. At Walmart, no insurance $4.00.
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