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genetic testing and insurance coverage?


Forum: Recurrent Miscarriage and Pregnancy Loss

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  #1  
October 14th, 2008, 09:10 PM
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Hello, I am new to the forum. I recently turned 36 and I had a third miscarriage 2 weeks ago. We are now considering a more serious work up. Our genetic counselor suggested we do chromosome blood routine for both of us. I believe our insurance will cover it but she mentioned that some people opt out and pay for the tests on their own for privacy issues.Has anyone heard of or done this? What privacy issues could be there? For coverage of any possible treatments in the future, is it better to pay on your own or go through the insurance? The tests are expensive so if anyone can shed any light on the topic I will be very grateful!

Many thanks,

miva
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  #2  
October 15th, 2008, 05:50 AM
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One of the reasons I can see people paying for their own tests is because when you sign forms to allow your insurance company to pay, you are also allowing the Dr.s or facilities to share your records with the insurance company. That could effect future coverages if they find that genetically you have a gene that causes cancer or Alzheimers and could deny coverage in the future on the grounds that it's a pre-existing condition. Not to mention that genetics are a very personal matter. I mean really, your genes are YOU. They are who you are and who you will be.

That being said, I allowed my insurance company to pay for everything they would allow. Mine pretty much paid for everything and I didn't have any problems getting covered for any subsequent procedures either. This is a personal choice that only you and you DH can make.
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  #3  
October 15th, 2008, 07:53 AM
plan4fate's Avatar I may bend, but not break
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Quote:
One of the reasons I can see people paying for their own tests is because when you sign forms to allow your insurance company to pay, you are also allowing the Dr.s or facilities to share your records with the insurance company. That could effect future coverages if they find that genetically you have a gene that causes cancer or Alzheimers and could deny coverage in the future on the grounds that it's a pre-existing condition. Not to mention that genetics are a very personal matter. I mean really, your genes are YOU. They are who you are and who you will be.[/b]


I agree with what's said up here.

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  #4  
October 16th, 2008, 10:37 AM
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Thank you for the replies! They helped me figure out the issue.

I actually called my dr's office and asked what exactly the tests will be. They said that these particular chromosomal tests look only at the structure and number of chromosomes and not at particular genes. The results will be relevant only to fertility issues ( no other deseases). Actually they mentioned that in case there is a problem, the insurance company will need to know the results anyway in order to cover related fertility treatments.

So, I decided to go through the the insurance. Hoping the results will be good.

Thanks again,

miva
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  #5  
October 16th, 2008, 02:07 PM
DawnN's Avatar Mega Super Mommy
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One other thing you may want to consider (or at least look into)...I had a BCBS PPO when I had my chromosonal testing done. The doctor's had to make sure to label it as recurring miscarriage (I think the terminology was recurrent spontaneous abortion...hate that term), but if it was ever labeled infertility/fertility testing during any of my testing, it was kicked back as uncovered and had to be re-submitted. Some insurances just will not pay for infertility testing or even work ups, but WILL pay for miscarriage issues as long as they are coded correctly. HTH
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  #6  
October 17th, 2008, 01:44 AM
Mommy4x4's Avatar Platinum Supermommy
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I'm not sure what Tricare [military insurance] will cover as far as genetic testing, but I know they help out with sperm testing, IUI, and even IVF/FET.
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  #7  
October 20th, 2008, 04:52 PM
beck12's Avatar Platinum Supermommy
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I agree that you want to be SURE it is covered if at all possible. Mine covered MY tests, but not DH & that ONE chromosome test was $1,500.00 for us. For us it turned out to be the answer too...so I am glad we had it done, but the bill was a bit shocking & not at all what I had expected.... I thought maybe $300-$500, but never $1,500.00.

Best wishes!
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  #8  
October 21st, 2008, 10:00 AM
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Just as Beckie said, you have to make sure with your insurance. Of course a good Dr.s office deals with those kinds of tests all the time and knows HOW to bill it to get the most benefit out of it. I didn't have to pay for any of our testing with my insurance but my DH only had a semen analysis so that may be something they are willing to cover as opposed to genetic testing. I on the other hand had everything right down to the genetic testing done and never paid anything. All insurance companies are different and some will and some wont.
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