IBX Keystone Health Plan East and Cell-free Prenatal DNA testing

alleycat39 · October 2014

Has anyone here done the MaterniT21, Harmony, Panorama, etc cell-free DNA testing and had it covered by their Keystone Health Plan East plan? I have my sequential screening on Tuesday and will be having one of these blood tests done, however not sure if it is covered (customer service wasn't much of a help!). I have a history of a pregnancy of Trisomy22, so I'm hoping to have it covered.

Thanks in advance for any insight!

litt1er4 · October 2014

My coworker (we have Keystone Health Plan East) was able to get it covered since she had a prior history, although she had to get it appealed. So you have to be persistent with it.

alleycat39 · October 2014

Thank you @litt1er4 . I'm prepared to appeal it and my OB said she is happy to write an appeal letter. Thanks for the heads up!

PhillyMomToBe · October 2014

I also encourage you to contact the testing company directly. I've negotiated with two different companies and both have been reasonable and helpful in regards to the testing costs.

alleycat39 · October 2014

Thank you @PhillyMomToBe - I did contact my insurance company with the CPT code for the test and apparently I am covered 100%. However, I know that does not in fact guarantee coverage when it comes down to it. If something is not covered, I'll certainly contact the company directly to negotiate!

ClareH1217 · October 2014

I have it and the genetic counselor said I could get the Verifi test for $25. I am under 30 and no history.

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IBX Keystone Health Plan East and Cell-free Prenatal DNA testing

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