Labs
Key takeaways
- You can choose where your labs are processed– don’t rely on your provider’s lab preferences.
- Labs at Quest Diagnostics® will be at or below the Benefit Amount and are often less than Labcorp, so you may keep the savings (once you've met your deductible).
- Labcorp prices match our Benefit Amounts, so you won’t be balance billed* (once you've met your deductible).
- JasonHealth often offers labs below the Benefit Amount.
Shopping for labs is a great way to save
Providers may default to doing labs in-house or at partner labs, but you can choose where your labs are processed to save money.
Pro tip: Use Quest Diagnostics or Labcorp to get labs at no additional cost. Our agreements with Quest Diagnostics and Labcorp ensure labs will be at or below the Benefit Amount so there is no balance billing once you've met your deductible.
To access this lab benefit, ask your provider if they work with Quest Diagnostics or Labcorp:
- If they do, ask them to include your Member ID number (found on your Digital Member ID card in the member portal) on the lab requisition form. Sidecar Health will be billed directly—no need to pay at the point of service for the lab work.
- If they don’t, contact the Quest Diagnostics or Labcorp location of your choice to schedule an appointment. When they ask about insurance, let them know you have coverage through Sidecar Health. If the representative is unfamiliar with our process, share your Member ID number (found on your Digital Member ID card in the member portal) and let them know to bill Sidecar Health directly.
If you are going under anesthesia or won’t be able to respond when your doctor determines a lab is necessary, request your doctor send labs along with your Member ID number to Quest Diagnostics or Labcorp.
If you want to choose a different lab, follow these steps:
- Ask your provider for a lab requisition (lab order form).
- Know your “Benefit Amount” before you schedule your labs by inputting the associated medical procedure code (often called CPT code) associated with your lab test into Care search.
- Bring your lab requisition to your appointment.
- Upload an image of your itemized medical invoice to the member portal under the “Expense” tab within 90 days.
- Forward the results of your labs to your provider.
Breaking down your lab benefits
- Preventive care labs (i.e. screening) will skip the deductible (if applicable). You will only be responsible for any amount above the Benefit Amount.
- Diagnostic labs (i.e. tests to diagnose an issue) will not skip the deductible (if applicable). You will be responsible for meeting your deductible, plus any amount over the Benefit Amount.
- You do not need to shop for labs in emergencies. For labs that are part of emergency care, you will only be responsible for covered charges up to your deductible/MOOP (Maximum-out-of-Pocket)
Sample scripts for talking to your provider about labs
REQUESTING A LAB REQUISITION FORM
- "My insurance works differently, they pay fixed Benefit Amounts for each test and I have the ability to shop for labs."
- "I will have to pay the difference when the lab charges more than my plan’s Benefit Amount so I’d like to find the lowest cost."
- "Can you please provide a lab requisition so I can search for my own lab provider?"
REQUESTING PROVIDER SENDS LABS TO QUEST DIAGNOSTICS OR LABCORP
[Use script above with this addendum] "Please send my lab requisition to [Quest Diagnostics/Labcorp]. Please note my insurance is Sidecar Health and my Sidecar Health Member ID is …."
More questions? Your member care team can’t wait to answer them. Chat with a real human on our website or at 855-282-0822. TTY: 711
*Sidecar Health does not utilize a network of providers. External websites and information on healthcare providers, including cost and quality information, is provided for convenience and informational purposes and is not an endorsement or guarantee of pricing, quality, or availability of the provider. Contact the provider for pricing and availability. Sidecar Health bears no responsibility for the accuracy, legality or content of any external websites or for subsequent links from an external site.