brca testing and insurance ???

My onc referred me to a genetic counselor.  Because the BRCA test is expensive ($3300 I believe, or somewhere around that amount) and not always covered by insurance, my counselor had to call my insurance company and get me preauthorized first.  Generally if the counselor determines cancer runs in your family, then they will recommend getting the test and they will call your insurance company to preauthorize it---you don't need to make the call yourself.  But if your sister is the only one in your family who has bc (that's IF she does), the insurance may or may not cover it if they don't see cancer in your other family members.  It depends on their policy.

I was DX in 06 first one in my family know of (however my mom died of Liver cancer unknown primary - she never had a mammo in her life) I saw a new obgyn who had a genetic counsler on staff - they were the first to recommend BRAC test as I was DX before age 50, anyway I have Blue Cross and they paid the entire amount. I was told by the counsler that they draw the blood send it off to lab -the lab will contact the insurance company and if insurance won't pay they will contact your DR/you before proceeding - I was also told results could take up to 6 weeks mine were back in less than 2 - hope this helps. 

I have BCBS insurance.  Met with geneticist today and was told that since I was diagnosed at a young age, 38, the test is considered medically necessary even thought I do not have a strong history of bc or prostate cancer in my family.  BCBS will cover it if it is determined to be medically necessary.

HI,i was wondering if anyone knows if tricare(military insurance) pays for the testing.i just called them and they said i needed the procedure code to ask my doctor or nurse for it.i go next wed for pre-op for a lumpectomy(hopefully everything will be benign) was told by a radiologist it is probably just a fibroadenoma.however been to young survivors website and talked to a couple of girls on there and they were misdiagnosed by radiologist and dr and happened to be cancer and my husbands aunt was told hers was benign and wasn't so with my family history( uncle breast cancer ,prostate and various others,grandma breast cancer,cousin died from breast cancer, mom lump with calcifications right now and idiot dr in fl just watching since dec.)i don't want to take any chances. thanks

I was wondering if anyone could give me more insight and any experience on the BCRA testing.  I have talked to a genetic's counselor and she thinks that I might be a candidate to have this test.  I was diagnosed in January with LCIS and ADH at 41.  My mother had benign biopsies in her early forties as well, but she died 6 years ago, complications from diabetes and kidney failure at 62.  The only relatives I have are a great aunt and 2nd cousin who have both died from BC.  So far from what I have been reading, the only testing usually done is when you have a mother or sister with BC.  I would like to have it if my insurance will cover it.  But at the same time, I'm scared to find out.  I have also had a large mass on my ovary taken out this year, so I know something is going on there as well.

Well anyway, thanks for the input.  This site has given me much advise from all you Ladies, thanks for sharing.

Holly 

I recently received my genetic testing results.  And I was negative.

When I called my insurance company to determine if they would cover the testing, they said they do not cover genetic testing.  However, I met with the genetic counselor at my medical oncologist's office and she wrote a letter with my risk rate and it was approved. The total cost was $3200, I just have a small co-pay of $247.00. 

My mom passed at 58 from ovarian and I was 46 when diagnosed with DCIS.  My 49 year old sister met with a genetic counselor and they determined she should not be tested as she didn't meet enough of the criteria - this was before knowing my results. 

Even though I am negative for both BRCA1 and 2, I will continue to be screened for ovarian cancer , having the blood test CA-125 and also a transvaginal ultrasound.  I am on tamoxfin for 5 years, so the TVU is part of the normal screening (higher rate of uterine cancer).   I will also continue to have an internal every six months at my ob/gyn. 

Before my diagnosis, I was on the birth control pill as it has been shown to reduce the risk of ovarian cancer.  My cancer was hormone receptive, so I had to get off the bc pills immediately. 

I had already decided that I would have my ovaries removed if I tested positive. 

It is so personal deciding on these surgeries, as we've all heard about Christina Applegate's recent double mastectomy as she tested positive for BRCA1.   Everyone needs to decide for herself what is right. 

Good luck to all.

You ladies that had the testing?  Was there a % they gave in regards to the chances you had it?  I only talked on the phone with the genetics dept, and they said just roughly from my family hx, that she thought I had like an 8% chance of having either of them.  And unfortunately I don't remember if I knew at the time that a great aunt had had BC also.  IF it comes as a genetic thing to me, it will be through my fathers line most likely.  Both sides have only 2 girls in each family line, mom and aunt, dad and aunt type of thing back a few generations, so I guess then they use the dad's side also they said. There I had my dad's sister and his aunt who had BC, and a grandmother who died of cancer but it was unknown primary. When they opened her up back in 1964 to do a gall bladder removal, they found she was full of cancer.  At that time, they would just close you up and send you home to die, which is what she did, so we have no idea where it started. She would have been early 60's and apparently had it for some time to have been riddled with it as they said back then

Just curious, as this has never been discussed with my docs, but wondering for dd's and sisters sakes.  Anyway know what they use as a cut off to do testing? I remember this lady saying they would suggest for me, but I was wondering if you ladies who had already remember the %'s they might have mentioned before testing you?

I'm BRCA2+.  My BS wanted me to be tested because my older sister lost her battle with breast cancer at age 47---she was dx at 42.  I have Blue Cross/Blue Shield and they paid the entire cost of the test.  My test was not run through until Myriad informed me that my insurance would pay.

My 23 year old daughter tested positive also.  

I learned alot about BRCA from  facingourrisk.org 

wish - having BC in a dad's sister, aunt, and grandmother might be well worth a consultation with a genetic counselor.Especially if, as you say, there has been a preponderance of sons born, so not that much opportunity for 'female cancers' over the years. I technically would not have qualified under the percentages, as I had only one first degree relative with BC - my sister - and no one else for generations on either side. But she was diagnosed at 29 and I was able to show that no female on my father's side had lived beyond thirty-five for the hundreds of years we had records so an exception was made. I hope and pray you would turn out to be negative, but it is far, far better to be informed.

For your daughter, if you should test positive, make sure she has adequate life insurance before getting tested herself. Genetic results re life or group health insurance is protected by most state laws and will be protected by Federal law on top of that in 2009.

Lisa

BRCA-1+

My insurance paid for my BRCA test, too.  I was 39 when diagnosed and had no knowledge of any family history, as I am adopted.  We initially paid for it out of pocket so that my results would not be in my medical records.  When it came back negative, we submitted it to our insurer, who paid.  So, we did not have to be preauthorized.

Tym... I am also BRCA positive. I also have a 12 yrs old daughter - and I don't know (and will not know for years, as they will not test her until her 18th year of age) if the problem will come for her.

It broke my heart when she asked me last year if her budding breasts would some time become a cancer.

This is a great topic.  My wife just had her testing yesterday and we are hoping things come back negative .  My wife's mother had a double mastectomy 20 years ago and had one of her ovaries removed.  We have BCBS and it appears to be fully covered.

 Can anyone else confirm: 1) Children under 18 can't get tested? 2) which insurance companies have declined coverage?

Erik

http://route53.wordpress.com

I will be having the test done 10/3.  My Onc. said I should know the results the following week.

I had ILC Stage I at age 43.  I had my ovaries removed last Oct.

I just visited my obgyn and she reviewed my family history and that was the first thing we discussed when she walked in to the exam room. Honestly  I had all intentions on discussing the facts of my family history of cancer and was amazed at how she was so willing to educate me with facts and helping me make this decision that same day. She is absolutely amazing and thank god she educated me with some many facts and was able to handle my blood work the same day. I knew alot of my family history due to a recent visit back home. (NJ) I lost my mother to breast cancer at the age of 44, Two Aunts paternal side diagonsed with Colon cancer which one lost the battle. My father just recently had 10 polyps removed and now has to visit every 6 months. Counsin who is my age 34 had a precancerious polyps removed as well as his sister (kids of aunt lost the battle). She had no questoin if i qualified as far as family history. In my years I have been to many funerals and all due to cancer! Sad and that is why i am getting tested and when my girls get older 6,3 and 2 of age they will too be tested. Wish me luck in my results. prayers up blessings come down!