Insurance Coverage for Genetic Testing for Cancer

Genetic testing can reveal whether your genes have mutations that could increase your cancer risk. The tests can be expensive, so you should find out whether your insurance company will pay before having the testing done.

Coverage Varies by Plan

• Costs for genetic tests can vary from several hundred to several thousand dollars, according to the National Cancer Institute. Each health insurance company's policy varies on test coverage, and whether the patient must partially pay. If an insurance company's policy does not specify its genetic test coverage, the company might need to review the claim more before deciding whether to pay it.

  Anyone who is considering having genetic testing done should contact their insurance company to verify their coverage before scheduling the test, and if necessary should obtain written approval to submit to the testing facility prior to the test.

Most Companies Set Guidelines for Testing

• According to a U.S. Department of Health and Human Services review of publicly available insurance plans, most covered genetic testing if a disorder was prevalent in the patient's family history, if the test's result would influence treatment of a condition or if the patient met high-risk criteria. Most of the insurance companies surveyed would not cover a test conducted out of curiosity.

At-Home Testing Kits

• People can buy at-home genetic testing kits on the Internet for as low as $30. However, the Government Accountability Office issued a report in July 2010 that called the tests "misleading." The report also sounded concern about the tests' "deceptive" marketing practices. The Food and Drug Administration has not historically regulated the tests, but in June 2010, the agency sent letters to several genetic test manufacturers, informing them that the companies needed FDA approval to sell the products.