Is the maternity21 test covered by insurance?

haylo33 · December 2013

I know it varies, but my insurance company was literally no help. They told me they won't know until it gets billed. I had 2 soft markers yesterday on my A/S and this would take the place of the amniocentesis. I tried calling the lab who does the test but they are closed. If you had the test, how much was it out of pocket?

pandadair · December 2013

Mine doesn't. But if you give your insurance the billing codes, which you can find online and/or get from the doctor's office, they should absolutely be able to tell you their policies on coverage.

Luckyu317 · December 2013

Sorry, @pandadair. I didn't mean to flag your post, darn chubby fingers. I tried to love it to remove the flag, but I'm not sure it worked!
*edit- it was removed. Sorry again!

Allibob · December 2013

Most insurance will cover it if you have risk factors, like an abnormal US or are over 35. Mine was covered due to age, so I didn't have an out of pocket expense. Sorry your AS was abnormal, and I hope you're able to find some reassurance with this.

SweetTea420 · December 2013

I paid $79 for Harmony and I'm 26 with no risk factors. I have Humana insurance. I think you have a good chance of your insurance covering it since you had an abnormal ultrasound. I was able to find a policy on non invasive prenatal testing on Humana's website that helped a lot.

Kageer · December 2013

I am over 35 and the test was not covered by my insurance. They said the lab was "out of network". But similarly they told us they wouldn't be able to let us know if it was covered until we did it. We decided to do it anyways knowing we would pay out of pocket. It was around 800. We have golden rule a division of united health.

dragossoul84 · December 2013

I'm 29 and mine was covered

cmitch01 · December 2013

I had the test done two weeks ago and haven't gotten a bill or explanation of benefits yet. Our genetic counselor said that since the test is still pretty new, a lot of insurance companies don't cover it but the lab will only hold the patent responsible for max $235 regardless. Our insurance company also couldn't say one way or another before the test was done. I'm 27 and had one soft marker on our A/S. We chose to just go for it since it would be the closest answer next to an amino. Best of luck to you with all this!!

Beegirl99 · December 2013

Mine paid because I will be 35 at my due date.

Storrmys · December 2013

We had it done too because we had a soft marker also ... Our will be covered if not by my insurance then by Tennessee's version of Medicaid( which we have for secondary) .. it came back completely normal and I'll be 43 when little Gavin gets here

Lauren5905 · December 2013

I called the lab and they were very helpful. My insurance was considered out of network, but the lab will bill the insurance to see what they will pay. Then they guaranteed that I would have to pay no more than $200 out of pocket. I was more than willing to pay that price.

RedInLove · December 2013

I'm having the Harmony test done, and was told my by doctor's office it's covered. I'm not sure if that's standard, or if it's because I'm AMA. I'm sure your doctor's office could provide those billing codes to you so you can call your insurance back.

ezelma · December 2013

I had the Maternit21 at 13 weeks because my 12-week blood test came back 1 in 60 for Down's. Mine was 100% covered by my insurance, but my doctor said it would have only been around $300 if I had to pay for it myself. For peace of mind, it is well worth it. The only thing is you have to wait longer for the results (a week-10 days) than with an amnio. Good luck!

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