Pregnant after 35

Did your insurance cover NIPT?

Was a test like Harmony or MaterniT21 covered by your insurance due to advanced maternal age?

Re: Did your insurance cover NIPT?

  • sidey1sidey1 member
    My insurance was billed almost $3,000 and I ended up paying $80 I think which I really didn't think was unreasonable. I don't believe it had anything to do with my age, my understanding from my OB office is that most insurance companies have now negotiated rates with the labs so they're able to cover the testing at a higher % because they're being billed less. Of course it's all dependent on what insurance and plan you have.

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    Me 43 DH 48 Not actively ttc, surprise BFP on 1/6/11! 4/1/11 m/c our sunshine at 16wks after complications from CVS test.  *5th cycle after loss 12/6/11 BFP! Missed m/c at 9 weeks 1/21/12, trisomy 14. Two Chemical PG 3/12&7/12
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  • I'm on a high-deductible plan; but, the test DID count toward my deductible.  We paid about $800 for it.  (Yeah, we reached that deductible in no time, lol.)
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  • HWKIHWKI member
    I had Natera. They billed my insurance company nearly $8000! My insurance company wouldn't cover a penny because it was an "out of network lab". Natera told me the most anyone will pay out of pocket was $200, but the bill they would send would match the insurance company's so to ignore it and call for a "fast pay option" that would be max $200. I had tried to call BCBS beforehand to verify what they would cover and they gave me a run around refusing to even give me a ball park number. Try looking up the company's website of the test you will use and call them directly.
  • mine was over $7,000 and not a bit covered by insurance
  • Mine was, but I was told it was because I was "double indicated" - my age plus the fact that I have a sibling with Downs Syndrome.
    We still got the run-around from the insurance company, though.
  • We did Materna Plus and our insurance covered it. Any time we're worried about insurance covering something, we ask the doctor if there's any way they can bill it to make it more likely.
  • I had the Harmony done, and my Humana HMO picked up the cost. Although, we excluded gender chromosomes, because we would have had to pay out of pocket for that.
    TTC since 10/09 Me-43 DH-44 RE and testing 10/10-11/10, Recommending IVF 1/11 New RE AMA and DOR-DH low motility IVF #1.1 cancelled 3/11 due to poor response IVF #1.2 May 2011, one perfect 8-cell embryo, 3dt-BFN, IVF #2.1 Converted to IUI d/t poor response. New RE 9/2011. IVF 2.2 completed using HGH,EPP,DHEA, Q-10 and accupuncture. Transferred one 8-cell, grade one embryo on 10/19. BFP 10/31/11 Chemical pregancy on 11/2/11. Started stims for IVF #3, our final try, on 12-2-11. ET on 12/18. Transferred 3 Grade A embryos-BFFN Planning DE IVF, late March/early April- Donors ER expected to be 4/2-4/4. PAIF/SAIF welcome
  • I have CareFirst, and the doctor told me I can either do the Harmony test, or the NT scan ultrasound. Then it turned out that both were covered because I'm 40.
    Me: 41; DH: 49
    Married in 2010. 
    Laparoscopy for endometriosis - July 2010.
    BFP#1: Jan 2011; MMC March 2011
    BFP#2: Nov 2011; Blighted Ovum December 2011
    Diagnosed with high FSH and DOR - January 2012
    BFP#3: (Gonal-F, Trigger + TI) - May 2012; DD born Jan 2013 (c-section because of partial placental abruption)


    December 2013: FSH 27, AMH < 0.03
    A few medicated TI cycles in 2014.
    BFP#4: (Gonal-F, Trigger +TI) - Nov 2014; DS born July 2015

  • LMJLLMJL member
    I think mine was. I haven't gotten a bill yet. It was 5 weeks ago. But so far it looks like all my genetic testing has been covered. I had Harmony (not the gender revealing one, we want to wait anyway) & a ton of other genetic tests as well. It looks to me like they were all covered by my insurance (Amerihealth NJ gold through the marketplace) but I'm always nervous to call & ask. They seem fairly disorganized over there & I'm always hoping something might get missed. :)
  • ErinkaErinka member
    I'm not sure! I'm 35 and have premera. I've usually had pretty good experiences with premera so I'm hoping whatever nipt my dr recommends will be covered.
  • All you ladies make me very grateful for my medical coverage! Mine was covered b/c of age. I had NO IDEA they charged so damn much for these tests!!
    We don't get the brake down in cost b/c we have tri-care (military) ... Unless we go to an outside provider we never see what is billed.
    The only downside is it's an all or nothing system ... Either it's covered or it isn't.
    It actually makes me quite angry that anyone could or needs to charge 6,7 or 8,000 for a blood test!!
  • euromomeuromom member
    edited June 2015
    OMG. I can't believe how much they are charging!  It's such as scam!!! I live in Europe. I'm getting my NIPT done at the end of the week and it cost 600 euros. I will pay for it and then submit the bill to my insurance company because they aren't sure if it's covered.  
    These prices they are charging in North America are completely ridiculous.  It's the same test.
  • ErinkaErinka member
    edited July 2015
    I just learned that my insurance will cover the MaterniTi test because I'm 35 but the copay is $400.
  • I'll be 35 when I deliver and I had the NIPT test thru Illumina and paid $20 co pay with Kaiser HMO
  • I have a high deductible, so i ended paying about $800...but i called my insurance first and clarified that they would accept the claim from the office/lab and it was a covered procedure. Always call your insurance yourself. The MD office cannot be held accountable if they get the info wrong, or misquote you.
  • ErinkaErinka member
    Anyone have premera and get it covered?
  • I have united health Care and they really sux as far as insurance goes..the cost was 10,000 bux for the testing, but was told that no matter what they cover and we git billed, to wait for the second bill.. Cuz in the end the charge will never b over 99.00 from me to pay..
  • We also have united health care and were told the same thing about only being charged $99 by Progenity for the test. It has been 8 weeks and we haven't seen the bill yet so I still stress. Last time we did the natura test and were charged $199.

  • Mine was the Panorama by Natera that someone else mentioned. I was told the bill would come for about $800 and I could negotiate it down to $100-$200. They billed my insurance for about $7k and I never got a bill for anything. I also haven't met my deductible yet, and I'm pretty sure it wasn't covered bc of my age, or my doc would have mentioned it.
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