Insurance and genetic testing

CeciliaVera

Hello! If your health insurance covered your testing for genetic mutations...how long did you have to wait in order to have that confirmed?  I had my first genetics appt about 6 weeks ago and am still waiting to hear if my insurance will authorize the testing.  My risk was calculated at around 10% (small family tree = not a lot to go on); the genetic counselor said that insurance coverage is usually granted when the calculated risk is 10% or higher. 

By the way, I was diagnosed at age 41 with stage 1, grade 2 IDC + DCIS in August of 2013, oncotype 16, no node involvement, and had a lumpectomy and radiation.  

Thanks in advance for any info.  Good health to you!

april485

Hi Cecilia,

Although my dad's side had many related cancers, (colon, uterine, liver and pancreatic) all diagnosed when in their 40's and 50's, my insurance company turned me down for the test. I was pretty upset but they said not enough correlation. Hope you get to have yours. I went through the whole genetics thing including blood tests only to be told no. I had Cigna as my insurance carrier if that makes a difference for you and am told they are tough in this area. Now I have Conneticare and may try again. No breast cancer in my family but colon is related as is uterine so may have a shot..who knows? Best to you and hope you get an answer soon!

Miller1353

0% family history at diagnosis. Insurance (anthem/BCBS) agreed to testing within a week.  Their protocol was to approve if diagnosed under age of 45. I met the criteria.

Macintx

I was denied also, because apparently I didn't meet any of the criteria.  I heard it costs about $3000 to get it done yourself.  I was 49 at diagnosis, so not young enough, no family history of BC or OC, not Ashkenazi Jewish, etc.  My Dad did have Colon and Prostate cancer, and men who are BRCA+ are more prone to that, so I might have to see if I can go from that angle.  I met a girl in my support group who was told she didn't qualify because she was very low risk, so she paid for it herself and found out she was positive, and her Dad was positive also.  So you can get it from your Dad's side of the family.  I just worry because I have an identical twin sister and a daughter.  I know it can still be hereditary even if you are BRCA-, but it would be nice to know for their sake how vigilant they should be.  FYI she said it was $3000 for her to be tested, but once they learned she was positive, it was only like $450 to get her parents tested.

Calsacienne

At first, my sister was denied. She was told that I had to be tested first. My sister had a rare form of lymphoma when she was 37. Lymphoma survivors are at risk of BC because of the rads to the chest. I'm in France and they wouldn't test me while in treatment. 

They said no because "not enough family history". This is tough when you come from a small family with only children or only one sibling. We're Ashkenazi Jewish background. 

She had the head of the clinic come out to talk to her. She explained that she was already high-risk and needed to know. They approved her and she was negative. 

My turn is on Friday and I won't know for several months. 

elabee

6 weeks seems like a long time to wait to hear back. It only took a couple of weeks for my insurance company to approve the testing. I was 34 at the time with little information about my family tree.

I would suggest calling them and asking what the hold up is, that might help. 

MelissaDallas

Mine took 4-6 weeks. 

Since she is in France & that could be the norm there.