Genetic Testing

presh116 · January 2016

I'm 11 wks today and had my sequential screening. They asked me if I would like to do a test called verifi that detects higher than the normal test for down syndrome and it will detect the baby's gender. I told the Dr. Yes and we will be finding out if our baby is a boy or girl some time next week. Of course praying for a healthy baby but can't wait to know.

imakeeff0rts · January 2016

Did you have a question, or...?

MrsAddy24 · January 2016

That is awesome...i wouldn't mind getting one but i dont think my insurance would cover the cost.

Bookhousegirl · January 2016

That's great that you are able to find out so soon!

This would be a great post for the weekly randoms thread, or your weekly ticker change group.

searchingforameaning · January 2016

I think I am having the same text next week. How do we know if insurance covers it? I assume if the Dr. recommends it then insurance would cover. I am excited to find out if its a boy or girl so I can hit up some of the clearance sales going on.

mouse1029 · January 2016

You have to qualify for insurance to cover the verifii test. When I had it done with my DD you had to be ama, have a family history of genetic issues, something had to be seen on a level 2 sono or a history of pregnancy loss.

Maybe things have changed, but that was the terms. Otherwise it's out of pocket.

blond1230 · January 2016

I'm having this test next week. It's amazing what they can do now, when I had my son two years ago this wasn't offered. I called insurance and it's covered but I know it isn't for everyone so definitely check. My friend had to cover it and it was over $1000. Each insurance is different I don't have any of the prequalifications listed above, my insurance actually said there are only five tests in the whole spectrum they dont cover when requested by a doctor.

amandam925 · January 2016

I'm planning on having this test (non-invasive prenatal testing or NIPT) at 10 weeks.

From my research into insurance coverage, a lot of health insurance companies cover it if the mother is 35 or over. More and more insurance companies are covering NIPT, though, since it's non-invasive, extremely accurate, and it's "cost neutral" to insurers.

You can call your insurance company and ask, but the woman I spoke to at mine had never heard of NIPT and only knew the specific laboratory names (like Harmony or Verifii) of tests that were covered (after some research). My insurance company was very nice about all my questions and did everything they could to answer them, though -- so I'd say definitely call and asking if you have questions about coverage.

charmedlifex3 · January 2016

I called my insurance company about it. The one my doctor recommended is called Harmony. If anything, they will go back to the doctor for justification. The doctor will have to write a brief explanation of why they recommended *this* test. And no, "The patient wanted to know what color to paint the nursery" won't fly Usually the doctor won't recommend it unless there is some ability to justify it, for just this reason. Advanced age of either parent (in our case, my husband) a family history, etc.

My insurance confirmed they cover it, as long as it is performed at a doctors office, under a doctor's recommendation.

I admit, I am excited we're getting to peek at the sex, but mostly excited we'll be getting reassurance everything is okay. My husband has been stressing after reading a bunch of articles about how after age 36 a man is twice as likely to contribute a mutation as at age 20. I am hoping we'll be able to put his fears to rest in a few weeks.

pelorunningmama · January 2016

I'm not sure how accurate this still is, but I had my first child in October 2013. We did the Harmony testing because my doctor said it was pretty much standard protocol. Not thinking, I agreed and figured insurance would have no issue. Of course, my insurance ended up saying it isn't a standard test and they wouldn't cover it. The bill for me was over $1,200 I think. But, I called the phone number on the invoice and spoke to someone at Harmony and they told me if I write something on the bill and enclose a check for $10 everything was covered. Totally sounded like a scam, but it worked. I guess it was their way of doing a "discount code." At the time that info wasn't publicized and we were going to pay the full amount. If you do want to do the testing but insurance won't cover it, I would give the company a call and see if they still offer that.

charmedlifex3 · January 2016

@lwc1112 Wow it's dropped! OOP costs for that test now was estimated at $130 by my doctor if insurance did not cover it.

smilormarie · January 2016

Since I'm AMA for this one (36) I'm going to ask my obgyn for the MaterniT21 test for the chromosomes As I will have already been released from the fertility doc. There's Verify, MaterniT21 and I think some other test (I see in the post above its called Harmony - thanks for triggering my memory!) that all do the same thing - provide the full chromosomal analysis including the sex chromosomes. My friend had it done at 35 and opted not to find out the gender and the doc kept it a secret from her until delivery so she and her husband could be surprised.

amandam925 · January 2016

Is anyone else holding off on sharing the news of your pregnancy until after you find out the results of the testing?

(My family history suggests that I might have a Robertsonian Translocation and I could be a carrier for Downs. So, we're keeping things private.)

amandazap · January 2016

imakeeff0rts said:

Did you have a question, or...?

Genuinely asking...does it have to be?

I find it interesting. I've never heard of this test and will now ask my OB.

lalalorelai · January 2016

If you want to know whether the specific test is covered by your insurance, call your doctor's office and ask for the billing code. There may be multiple (like one for the blood draw, one for the lab, etc.). Then call your insurance company with the exact billing codes and they'll be able to tell you what's covered. They may or may not know the tests by the brand name, but the billing code they will definitely be able to look up.

jle1021 · January 2016

We opt out of the genetic testing but my dr said if we were wanting to do it then they would verify with our insurance company first to see if it was covered.

presh116 · January 2016

Thanks for sharing Ladies, I was excited to share my news. My Dr. Told me it would be $100.00 out of pocket. I was wondering who has done it and who was going to do it. Thanks

tinkerbell11210 · January 2016

My sister in law just had this done at 12 weeks. She is due in April and had a few miscarriages before this pregnancy so that was her reasoning for getting the test. plus they were able to find out they are having a healthy baby girl. I talked with my dr about the Harmony test at my first prenatal visit. She checked my insurance right then and told me our cost would be about $100. We have BCBS PPO and I was told that they normally cover it.
I am getting the test at 12 weeks. To me and my husband it is worth it. He really wants to know the gender.

bananers · January 2016

I'm getting the test because I am 35 and have a history of losses. Finding out the sex early is a nice bonus, but please try to be respectful of those who are doing this as a diagnostic test (which is what it's designed for). Some of us are genuinely scared of what the test may reveal. Before you get all "squee, boy or girl?!?!" please think carefully about what you would do with the knowledge that your child may have a chromosomal abnormality.

Sonicstef · January 2016

I had it done last time and it was a nice sigh of relief when I got back great results so I didn't have to think about the amnio or CVS. This was before they told you the sex. I'll definitely be getting it again.

Wolfie646 · January 2016

I have my Genetic ultra sound and counseling/blood test this week. A bit nervous because my cousin has Down Syndom, and I'll be 35 when I deliver. But keeping positive

presh116 · January 2016

I hope all goes well for you @Wolfie646
I got back my results today. Baby is very healthy and a Girl!!!! I'm so excited good luck to everyone.

whitney812 · January 2016

This test was TERRIFYING for my sister in law, and best friend. Both of them were told at this test that something was wrong with their baby, then a couple weeks later after normal testing they said "oh, never mind all looks good!" They spent weeks crying over the original tests. I will be skipping this, not worth the stress.

jmknox · January 2016

Did anyone have trouble with their insurance NOT covering the test? My midwife just told me that they opened up the MaterniT21 test to everyone a month or so ago. I am going to call and see if it's covered. I am not quite AMA yet at almost 33 but my midwife thinks it would be a good idea.

misspuppychow · January 2016

I did the Panorma to find out gender. I opted not to receive the genetic results as I'm not having an amnio (I'm already high risk of m/c) and it won't affect whether or not I keep the baby

My insurance pays for it at 100% so why not?

HeyStVincent · January 2016

I am just under the threshold for getting the cell free DNA testing done (this is the genetic test I think most of you are referring to). You have to be 35 to have insurance cover it and I'll be 34 + a few months at that point. I figure my risk of chromosomal abnormality is probably almost identical to a woman who delivers at 35 since I'm only going to be 7 months short of being 35. So, we are getting it done even though it's not going to be covered. My OB discounts the test if insurance doesn't cover it (he must be able to write-off the incurred costs), so the most we will pay out of pocket for it $550. I'm having it done in 3 weeks if all continues to go well.

I think it's a good idea to have it done early if the result will change whether or not you choose to continue with the pregnancy. Also, if the fetus has a condition that is incompatible with life outside of the womb, you're better off finding that out at 10 - 12 weeks as opposed to 16 or 20 weeks. However, if you're young and healthy with no significant family history of chromosomal abnormality, then it's probably not worth the cost.

TX126 · January 2016

I had the Verifi done last Friday - I won't be covered by my insurance, but Progenity said they would reduce the cost to $99 no matter what, whether insurance covered part of it or not.

shalsroy · January 2016

I had the NIPT test done nine days ago, and though the lab said it takes 15 days to get it back, my results were in when I called today. In Canada there is provincial health coverage depending on age (40+), past medical history, or risk of complications. I am relieved that my results are fine. ☺

blond1230 · January 2016

Went in today for my Verifi test. The doc I saw today was a different one than I had last one and was very surprised that I was there for the test. I told him the doctor last time recommended it if my insurance covered it, and I called and they said it was in fact covered. The doc said he is so surprised that he would draw the blood, let me call again, and run it when I call back for sure.
So I called my insurance AGAIN spoke to someone different and she said the person I spoke to last time left out that its only covered if its pre-authorized, which would be the case if I was over 35 or due to medical history.
So please check with your insurance for sure if they say its covered and what authorizations if any are needed, and get a persons name (my doc said to do that lol). Otherwise the doc said the cost is very high if you aren't covered.

mimihatesyou · January 2016

TX126 said:

I had the Verifi done last Friday - I won't be covered by my insurance, but Progenity said they would reduce the cost to $99 no matter what, whether insurance covered part of it or not.

this is exactly what my perinatalogist's office told me. they told me if i received an eob from my insurance company indicating that the test wasn't covered and that i may owe like the federal deficit, to call progenity and they will not charge me any more than $99. they don't balance bill.

i had mine done yesterday, after the nuchal translucency scan. during the scan, my doctor told me he was 85% sure i'm having a girl.

hgahagan · January 2016

I was just curious if anyone knows if these tests can accurately determine gender of twins?

presh116 · January 2016

My mfm group told me that it's not as accurate with twins. I specifically asked the question the test said it is 99.8 % accurate what is the .2%? She said woman pregnant with more than one baby. Hope this helps.

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