BRCA testing-insurance won't pay for treatment if test positive

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DesertMama
DesertMama Member Posts: 47
edited June 2014 in Triple-Negative Breast Cancer

My MO tells me that I should not have gene testing done until all my treatments are finished, as my medical insurance will refuse to pay for any more treatment if I am found to be positive. They will then consider that my cancer is a pre-existing condition if I show any hereditary genes.

I really want to know of course, since there is some ovarian (but no breast) cancer in my family. Even if I wait until I am finished chemo and rads, I will still face having to pay for BS followups, tests, further surgery etc. if I test positive, sigh.

Anyone else facing this?

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  • Leah_S
    Leah_S Member Posts: 8,458
    edited November 2012

    DesertMama, you might want to call your insurance and find out if the MO is correct. A genetic mutation that has not been tested before your dx for BC is not a "pre-existing condition". They might be able to make an argument for it if you'd had the testing. I don't think they can for a genetic mutation, though.

    Best of luck.

    Leah

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  • DesertMama
    DesertMama Member Posts: 47
    edited November 2012

    Thanks Leah. I will definitely check with the insurance company, but I am worried that my MO is correct, since he is the voice of much experience here, and there are not a whole lot of good choices for cancer treatment in these parts. (Wanted to add: I feel very lucky to have found excellent care for myself, but there is certainly a lot of dodgy health care around here.)

    Not sure, but I am imagining similar situations for your part of the Middle East. Hope you are feeling well cared for!

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  • Leah_S
    Leah_S Member Posts: 8,458
    edited November 2012

    Desertmama, I hadn't read where you live! I thought you were in the U.S.

    In Israel we have socialized medicine and it's very good and covers a lot. BC patients who are BRCA+ are covered, and anyone with BC or with it in their family is encouraged to be tested - there's a high rate of BRCA+ in the Ashkenazi Jewish population.

    If what your MO said about the BRCA is true, you might not want to be tested - or else see if you can get tested privately under a pseudonym (I'm not kidding, it might be necessary). Then you can decide what to do about any future decisions.

    Best of luck.

    Leah

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