Medicare coverage for BRCA testing?

I had testing earlier this year. Medicare (actually my Advantage plan) covered a certain amount of testing because I've had other cancers, and several family members have had cancer. But there was some testing they wouldn't pay for. If the test helped with potential risk for myself, it was covered. If it was to assess risk for blood family members, no. But it might depend on the type of cancers.

When I was dxd last year, Medicare covered all of my genetic testing, including BRCA. Granted I am 41 and disabled, so this may not be the case for all on Medicare, but I was thankful I didn't have to pay OOP.

Wishing you and your mother the best on your visit, appt, and I'm so sorry you are going through this again.

So sorry to hear that your Mom is having to go through all this again. I really don't know what Medicare covers so I can't weigh in on that, but I am guessing genetic testing would not change your Mom's treatment plan at this point. There might be value for you and any siblings to know if your Mom carries a genetic mutation that you might have inherited, however, so I wanted to mention the testing from Color Genomics. This is an at home test that runs about $250, I think.

It tests for mutations in these genes: APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CDKN2A (p14ARF), CDKN2A (p16INK4a),CHEK2, EPCAM, GREM1, MIFT, MLH1, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2, POLD1, POLE, PTEN, RAD51C,RAD51D, SMAD4, STK11, TP53.

I took this test myself. You have to have a doctor refer you for the testing, but you can use their doctor at Color Genomics. After you get your results, you have the option of consulting with one of their genetic counselors by phone (this is included in the price). My results were negative so I didn't take advantage of their genetic counseling service, but it did help inform my decisions regarding what to do about my LCIS.

I heard about Color Genomics on these boards so there are others on here who have had experiences with this testing. Not sure that the test is as comprehensive as the hospital-ordered testing, but it's a good starting place in my opinion.

MelissaDallas, perhaps I wasn’t clear using the word ‘refer’, but Color is very clear that the testing is physician ordered & reviewed. From their website: “Doctors order Color. Color's clinical-grade tests are ordered by a physician who reviews your information to decide if testing is right for you, or your own physician. After you provide a sample, Color can connect you with a provider from an independent physician network who will review your information and can order testing on your behalf. If any questions arise, they will contact you.“ I used their physician rather than my own doctor when ordering initially, but I had the chance to send the results to my physician.

I believe we are saying the same thing, MelissaDallas.

To the original poster, pp729 - I just mentioned Color Genomics because it is a reasonably-priced option for your family if Medicare will not pay for this sort of testing. Sending along my best hopes & wishes to your Mom.