Genetic test with no family history recommended to you?

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  • Trvler
    Trvler Member Posts: 3,159
    edited March 2015

    Kayb: Yes, I will. But they did tell me it wasn't covered. My only argument is they were supposed to get authorization for any test over $100 and tell me how much it would be and they didn't do it.

  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited March 2015

    I was not tested but am wondering if I should have been. I wasn't tested since I am over 50. My sister who is older than me does not have BC nor does my mom(she is 91) or her sister (my aunt who is 94). My MO only asked me about immediate family. Is that how it works? I have been connecting with my cousins lately and there is a lot of cancer going on on my fathers side though none that I know of is breast. However my father only has brothers. That side of the family which I happened to take after is cursed I swear.

    Nancy

  • lgoldie
    lgoldie Member Posts: 120
    edited March 2015

    My onc. said no reason to check because no family history, and I was 55.  BUT my insurance paid the $4500.00 because I was triple negative.

  • besa
    besa Member Posts: 1,088
    edited March 2015

    Trvler - In addition to using the fact that they did not get authorization try to find your insurance company's guidelines for testing. (Often you can google the name of the insurance company and something like "BRCA testing" and " cancer." Also look of the NCCN guidelines and see if you fit the criteria. If you fit the criteria for testing under the NCCN guidelines you can use as the argument to get them to pay for testing.) I agree with above poster appeal the denial --- these companies sometimes count on fact that people will give up and leave money on the table.

    http://www.nccn.org/professionals/physician_gls/pd...

    https://www.nccn.org/store/login/login.aspx?Return...://www.nccn.org/professionals/physician_gls/pdf/breas...

    For the NCCN guidelines you need to register (it is free) to gain access. Look at the physician information - see 1st link above after registering.

  • Trvler
    Trvler Member Posts: 3,159
    edited March 2015

    Besa: That's really helpful. I googled Aetna's coverage and I think I might now be covered. It says multiple primary cancers. If I have just had another diagnosis of cancer in the same breast, is that a multiple primary cancer?

  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited March 2015

    kayb thank you so much for posting that. I don't fit any of the criteria so I guess my MO was right. Still my fathers side of the family scares the $h!+ out of me. Thanks again.

    Nancy

  • besa
    besa Member Posts: 1,088
    edited March 2015

    trvlr-if you have multifocal bc (two or more breast cancer tumors with the same pathology in the same quadrant) I don't think that counts as "multiple primary tumors". (I also had multifocal bc ) But -I am not an expert on this you need to check.

  • besa
    besa Member Posts: 1,088
    edited March 2015

    nancy2581- you might want to see a genetic counseLor. My experience is that they look into this more carefully and consider more than the mo's do. And they tend to be good dealing with insurance companies. When I first was tested a genetic counselor recommended additional testing for me because I had almost exclusively men on my father's side of the family-

  • Trvler
    Trvler Member Posts: 3,159
    edited March 2015

    I will definitely look more into this.

  • LostLittle1
    LostLittle1 Member Posts: 28
    edited April 2015

    Yes, it was recommended for me. I have no family history and am not Jewish. I was told due to the fact I'm under 50, my insurance will pay for the BRCA testing. I have no daughters or sisters but the doctor said it was important for my first cousins to know if my cancer is genetic or not. Also to see if I am at higher risk for ovarian cancer (my mother's sister had this in her 70's) and cervical cancer. I have heard from a nurse friend that all the female reproductive cancer types are related. I'm not sure if that is true or not.

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited April 2015

    Cervical cancer is mostly caused by the HPV virus, so it is not the same as genetically linked breast & ovarian cancer.


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