Laboratory Benefits

If your healthcare provider is in New York State and requires you to use laboratory services for testing, the In-Network Laboratory to use is Quest Diagnostics. If your provider is in New Jersey and requires you to use laboratory services for testing, the In-Network Laboratory to use is Lab Corp of America. Remember – the Laboratory to use is based on where your healthcare provider is located. (When Medicare is primary, you do not need to choose In-Network or Out-of-Network facilities. Always be sure the facility is a Medicare provider.)

To search for an in-network laboratory in your area, go to www.bcbs.com.

Examples below. For additional information, see the Plan Document.

In-Network Provider Out-of-Network Provider
Diagnostic Testing(out-patient hospital) $35 co-pay per day $70 co-pay per day, and 20% co-insurance
Imaging (CT/PET scans, MRIs)(out-patient hospital) $50 co-pay per day $85 co-pay per day, and 20% co-insurance
Chemotherapy(physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% & co-insurance
Hemodialysis(out-patient hospital) No co-pay $0 co-pay per day, and no co-insurance
Hemodialysis(physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% co-insurance
Radiation Therapy(out-patient hospital) $0 co-pay per day 100% of u&c (no co-pay)
Radiation Therapy(physician’s office) $25 co-pay per day $25 co-pay per visit, plus deductible and 20% co-insurance
Mammography(out-patient hospital or physician’s office) Paid in full. One baseline – women age 35- 39. Annual – Women age 40 and over. High risk, any age. 100% of U&COne baseline – women age 35- 39. Annual – Women age 40 and over. High risk, any age.
Lab & X-rays (out-patient facility) $50 co-pay per visit $85 co-pay per visit, plus deductible and 20% co-insurance
Lab & X-rays (physician’s office) $25 co-pay per visit $25 co-pay per visit, plus deductible and 20% co-insurance
Lab-Quest Labs $5 co-pay per visit N/A

 

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