DEXA Scans and Health Insurance

accidental dupe!

Unfortunately, I pay out of pocket for every DXA even though I'm on Osteo meds and it's supposed to be covered 100%.

My DXA place has TBS scoring capabilities. No facility offering that software takes my insurance. Now I'm kinda stuck and don't want to switch, since I understand patients should keep DXAs on same machine for most accurate tracking.

Luckily DXAs aren't super pricey. The place I use has a discounted "cash" rate.

I think insurance is required to cover if you're on osteo meds AND stay in network. Your network may have better choices.

If not, and insurance pays every 2 years, that's still not bad. Every other one will be covered if you get annually. Ask if they offer a cash/walk-in rate. Probably runs $75-125.

Thanks!
I assumed the cost of a DEXA was a lot more than that by looking at my insurance EOB's.
I will have to check at the Imaging Center where I get them and see what the Cash price is.

yes I was pleasantly surprised - for some reason, cheaper than mammos and breast ultrasounds which are quite a bit more expensive.

Hospital-connected imaging centers tend to be much higher cost than standalone places. (Facility charges on top of imaging charges.)

I am on Medicare and it is paying for a Dexa scan once a year. It could be because my osteoporosis is severe. I think it also pays if you are on a bone building medication to make sure it is working.

Thanks!
It is interesting to hear that Medicare pays more frequently than employer insurance. I have 3 years until Medicare
I will call my insurance.

If you are being treated for osteoporosis, your insurance is supposed to cover annual DEXA scans.

Also, regarding your comment “the DEXA scan is the only way to monitor the effectiveness of medication”, BTM (bone turnover marker) tests are another way to monitor the effectiveness of osteo-meds. You need to start by getting BTM testing before you start osteo-meds so you have a baseline. Unfortunately, most doctors who claim to treat osteoporosis fail to order these tests. If you are fortunate and have a doctor who knows what s/he is doing, your doctor will order BTM tests before prescribing osteo-meds. If it’s then determined that osteo-meds are the best alternative for you, your doctor will then prescribe osteo-meds and approximately 3 months after you’ve been taking the meds (or had the infusion) your doctor will run the BTM tests again to make sure the osteo-meds are having the desired effect.