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Help to get insurance to cover testing?


Ask-the-Expert Online Conference

Question from Unnell: My insurance company has denied my request for BRCA testing, even though I have a family history (my mom and a first cousin on my maternal side). The out-of-pocket cost of the testing is over $3,000! Is there anything I can say or do that will make the insurance company cover my testing? Would you, if you were me, proceed with the testing regardless of the insurance company?
Answers - Carol Cherry, M.S.N., R.N., A.P.R.N., B.C. It's hard to answer your question without knowing all the details of your particular situation. Your decision to proceed with testing is really a personal one so what I would do is not that relevant. Have you worked with a genetic counselor who has helped you understand the requirements of your insurance company for coverage? The reason I say this is because sometimes counselors can write letters of medical necessity on your behalf to the companies to request coverage. Sometimes we're successful and sometimes we're not.
Terri McHugh An alternative, if insurance does deny coverage after meeting with a genetic counselor, is to test a relative who has had cancer. That might be most beneficial.

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