Philadelphia Babies

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

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!
PCOS & ute crew member
BFP #1: 10/24/2012  EDD 7/3/13, missed m/c @ 9 weeks, D&E 
DX: Septate Uterus. Septum resection 6/4/13
BFP #2: 12/20/2013  EDD 9/1/14, missed m/c @ 7weeks, D&E
BFP #3: 5/26/2014 EDD 2/7/15, missed m/c @ 9 weeks, D&E- DX Trisomy22
RPL, Karyotyping, and SHG: All Normal
BFP #4: 9/6/14 EDD 5/16/15 Praying for our RAINBOW!
image
Baby GIRL on the way!!
**All AL Welcome**

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

  • 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. 
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    BFP 8/28/07, M/C 11/10/07

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  • 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!
    PCOS & ute crew member
    BFP #1: 10/24/2012  EDD 7/3/13, missed m/c @ 9 weeks, D&E 
    DX: Septate Uterus. Septum resection 6/4/13
    BFP #2: 12/20/2013  EDD 9/1/14, missed m/c @ 7weeks, D&E
    BFP #3: 5/26/2014 EDD 2/7/15, missed m/c @ 9 weeks, D&E- DX Trisomy22
    RPL, Karyotyping, and SHG: All Normal
    BFP #4: 9/6/14 EDD 5/16/15 Praying for our RAINBOW!
    image
    Baby GIRL on the way!!
    **All AL Welcome**

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  • 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. 
  • 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!
    PCOS & ute crew member
    BFP #1: 10/24/2012  EDD 7/3/13, missed m/c @ 9 weeks, D&E 
    DX: Septate Uterus. Septum resection 6/4/13
    BFP #2: 12/20/2013  EDD 9/1/14, missed m/c @ 7weeks, D&E
    BFP #3: 5/26/2014 EDD 2/7/15, missed m/c @ 9 weeks, D&E- DX Trisomy22
    RPL, Karyotyping, and SHG: All Normal
    BFP #4: 9/6/14 EDD 5/16/15 Praying for our RAINBOW!
    image
    Baby GIRL on the way!!
    **All AL Welcome**

  • 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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