Genetic testing and insurance coverage?

smoothobturator@hotmail.com

doc ordered the harmony test but I'm not ama or have other indications for coverage. The lab website is not helpful in what the out of pocket pay is. Anyone have to pay for this out of pocket? How much was it? I am somewhat surprised they would order a lab test that might not be covered

CaraBoonie

Call your doctor and ask them, I know my doctor's office acts as the go between with us and insurance so that we don't have to grapple with them. The lab my office uses never charges the patient for the screening, they just hash it out with insurance and take whatever they can get, but I know each is different. I would definitely call your doctor and make it abundantly clear that you only want the tests if they are covered and refuse to consent until you understand the financial ramifications

emzie54

I was told it would be around $200. I will find out for sure at the appt on Thursday. I tried calling my insurance company but they were not helpful because I didn't have a procedure code for the test. If you have the code you could try calling your insurance company.

neonpotatoes

I called insurance to see what tests they cover, basically said it depends on if it's medically necessary and to have Dr. Submit a note with claims.

smoothobturator@hotmail.com

Thanks ladies. Insurance sent me the medical criteria needed for medical necessity and I don't think I fulfill it. I will talk to my ob to see whether they think it should be covered medically and if they can work as the go between. Just want to make sure I know ahead of time (and also what I'm liable for if I go ahead and do the test without coverage)