the Vitamin D test-price scam

One of my patients, diligently trying to find out how much lab tests would cost him, was told his insurance wouldn’t cover a basic Vitamin D test. Instead, he was told he’d have to pay $260 out of pocket to get the test done.

Unsurprisingly, he declined.

This makes me furious for a number of reasons.

First, I obviously think that vitamin D is an important basic health test — especially, but not exclusively, for people who live in above 37º latitude (north or south). In Alaska and Oregon, we can’t make Vitamin D from the sun for almost a third of the year!

“Winter sunlight does not have enough of the UVB component that is essential for vitamin D synthesis. For all practical purposes, one cannot make vitamin D in cold climates in winter.” — via the New York Times

And of course we know that low Vitamin D is linked to a variety of negative health effects, ranging from bone health to mood disturbances, infection risk, musculoskeletal pain, inflammation and more. (See more on Vitamin D here and here.)

But second, and maybe equally infuriating, is the highway robbery of all of this.

Medical insurance should absolutely cover this important medical test. But it makes my blood boil that going through his insurance would force him to pay 10 times the price if he paid cash.

always ask about cash pricing

This is not even remotely an exaggeration. During our visit, I looked up prices for Vitamin D testing at one of the cash labs I use. It was less than $25.

This. Is. A. Scam.

How this works is all about the accounting shenanigans between insurance companies, labs, hospitals and even some doctors. That’s all beyond me. (“Dammit, Jim, I’m a doctor not an accountant!“)

I guess it’s great if you’re an insurance company.

But this is terrible for everyone else.

Keeping people healthy improves life for us all, both individually and collectively. And this kind of ridiculous price inflation harms patients, doctors and the community.

If you experience sticker shock trying to get labs through your insurance, talk with your doctor about cash-pay options. It won’t always save you this much money, but for some otherwise expensive tests it can make a huge difference.

End rant.


Header photo by Timothy Dykes on Unsplash