NIPT under 35 & Insurance/Out of Pocket

paperbirdlady · May 2022

FTM, healthy, 33 years old. I opted out of the non-invasive testing at my 12 -week check up because I didn't think insurance would cover it. I only did the genetic carrier testing for CF because my niece has cystic fibrosis and I don't want to be surprised. Well I'm a carrier so now my husband is going to be tested too.

I had a conversation with my husband and we want to keep this baby no matter what. The tests are just screening and not a guarantee. But now I'm thinking that I want the NIPT testing to get any potentially bad news out of the way at once. Plus if I can find out the sex of the baby early, it might helpe feel some of the excitement my husband feels. I haven't been feeling the way I expected.

Has anyone under 35 done NIPT bloodwork? Did insurance pay for any of it? How much did you pay out of pocket? Someone on Reddit suggested Invitae bit the price has gone up so I think it would cost the same ad getting it done at my OB.

knottie_knottie1 · May 2022

I'm also 33 and met with my OBGYN to go over genetic testing options this week and they suggested I call my insurance company for how much I'll be charged personally for the different tests. Luckily my insurance company covers everything but the co-pays.

Before you call your insurance company though, you'll need to speak with the clinics billing department and get the CPT codes and dx code(s) to provide to your insurance.

omnommer · May 2022

Yes, call your clinic to get the CPT codes and diagnosis codes then call your insurance to check. I’m not yet 35 and my insurance surprisingly covered my NIPT. They also can provide an estimate of how much it’ll cost. If you tell your clinic BEFORE the blood draw they can charge the non insurance price if insurance won’t cover it. But they can’t do that after. For mine, that would have been $500 at the non insurance price.

jcapor21 · May 2022

Is the NIPT called “MaterniT 21” with labcorp? If so they have a program called “every mom pledge” where the test will be $300. I also just got the prior authorization approval this morning for my test- dates are wrong of course- I’m 34

goodyblmp · May 2022

My OB/GYN uses Invitae for NIPT. I have no idea what the original cost of the test is, but at the moment my estimated out of pocket is $450. My provider assured me the cost is covered 100%, but that I also won’t know final cost until my results come back. When I logged into Invitae’s website it says they offer a self-pay option which would cost $99. (You aren’t able to submit the claim to insurance for reimbursement if you use the self-pay option).

cmmctee · May 2022

My OB uses Natera (Panorama is the name of the test) for NIPT. Our insurance did not cover it, so we opted to do a traditional first trimester screen instead which was covered by our insurance. It is not as accurate, and does have a higher false positive rate but like you, we are keeping the pregnancy regardless of outcomes. We also are not finding out the gender until birth so the determination of sex that comes with NIPT wasn't a draw.

dogmom19 · May 2022

I’m 29 and had the NIPT testing done. I teach special education and have worked with kiddos with disabilities for over 10 years now, so it wouldn’t impact us keeping the baby. I just decided I wanted to know so I could have a plan if we were going to have a baby with chromosomal disabilities. It was covered under TRICARE so we didn’t pay anything out of pocket.

hspg · May 2022

I didn't even think to ask about cost! I just assume everything is covered 😬. Now I'm hoping I won't be in for a rude awakening. But I get my blood draws right at my OB who is in the hospital. Idk how other states are but in NJ the hospital I'm at is in a huge network and usually they tend to work that all out amongst themselves. I'm 30.

jateim7 · May 2022

I just had the blood draw for it yesterday. They said they would try to bill my insurance, but if insurance does not cover it it would be $250. I am also 33

ElisatheBrave · May 2022

When I was pregnant with my first at 32 insurance covered it. But everyone’s is different. I’d like all the information at once just so I could prepare.

kmiddy · May 2022

jenlm19 said:

It was covered under TRICARE so we didn’t pay anything out of pocket.

Same, 29 and got our pre-approval from Tricare for it! Waiting for the results currently from last Monday

goodyblmp · June 2022

Just wanted to give y’all an update on my out-of-pocket costs for the NIPT - $418.

hg916 · June 2022

My OB uses Natera/Panorama as well and we'll see what it is this time but 2 years ago with our first they had a max out of pocket of $250 if you paid within a certain window

mac12822 · June 2022

I just had mine done last week through Natera. (I’m 34) I got an email from the company stating that if we went through insurance (we have our state’s health plan since my hubs is a teacher) it would be over $600 since we haven’t met deductible yet. Or we could have the option of self-pay w/o billing insurance for $250

wishingwell925 · June 2022

I have Aetna. The NIPT was covered and the carrier screen was $189 out of pocket. I’m glad we took the tests, we almost didn’t since I’m 30 and healthy. I am a carrier for an autoimmune disorder so my husband is now getting tested too. It won’t change anything for us but I do like having the knowledge and no surprises