BRCA testing

Brenda_D · 09-13-2007, 12:10 PM

If you had one, did your insurance pay for your BRCA test?

AlaskaAngel · 09-13-2007, 12:37 PM

Yes, except for the usual portion I pay for any testing. I do have good insurance.

A.A.

weezie1053 · 09-13-2007, 12:41 PM

Yes, my insurance did pay for the testing. I had a maternal grandmother with both breast cancer/melanoma and a brother with prostrate cancer. FYI, prostrate cancer in the same family is a red flag as well is the melanoma. I tested negative. I am a proponent of meeting with a genetic counselor irregardless of whether you take the test. My meetings with the genetic counselor was very informative.

Louise

dlaxague · 09-13-2007, 07:46 PM

This is a topic of interest to me right now. I'm in somewhat of a gray area regarding family history. I would like to do the testing (for our daughter's sake, and perhaps that of my ovaries), but insurance will not tell me if they will cover the test until AFTER I've done the test. They say that it's considered a "send out lab" and they do not pre-approve this class of test. So the only way for me to find out if they'll pay is to first do the test and incur the debt. I talked to the nurse at Myriad (the company that's marketing the test) and she said that BC/BS commonly handles it in this manner and that she doesn't know if they'll end up covering it, either.

'Just doesn't seem right. At least if insurance would say "no", I'd know where I stand.

How did those of you who saw a geneticist first go about getting that referral? I'm thinking maybe that should be my next step, as perhaps if the test is ordered by a geneticist (as opposed to my FP doc who is perfectly willing to order it), insurance might be more-likely to cover it? Or my appeal of their denial might be stronger, with geneticist backing.

Debbie Laxague

AlaskaAngel · 09-13-2007, 08:01 PM

Debbie,

By consult only, I saw an onc who "specializes" not only in bc but in genetics, and so her referral was authoritative. She referred me to the geneticist (although because I was already in the clinical trial for early detection of ovarian cancer, I'd already been counseled 3 years prior and just hadn't felt the need to get the test). The second time I saw the geneticist he made the referral without any problem. The geneticist referred me to Myriad.

-AlaskaAngel

Aunt - bc, died from brain mets
Aunt - died from ovarian CA
mother - bc
sister - bc
cousin - bc
grandma - bc

LAURIE · 09-13-2007, 08:17 PM

yes, united health care paid 100%.

SusieQ · 09-13-2007, 09:07 PM

I was adopted when I was a baby and do not have family history information. My Oncologist ordered the test and Aetna PPO paid 100%

tousled1 · 09-13-2007, 09:12 PM

My insurance paid 100% for the genetic testing. I have a very strong family history of both breast and ovarian cancer on both sides of my family. I tested negative.

Linda · 09-13-2007, 09:19 PM

Hi all. Here's my info:
I was advised to be tested because both my grandmothers' had bc (one in her 40's, one at 70) and I am an Ashkanaze Jew, which is a high risk ethnic group. I had something like an 11% chance of carrying the mutation, and saw a genetics counselor at a big University hospital prior to the test. My insurance paid the whole cost (Cigna) -- however Myriad would not run the test until the insurance clearance went through. I tested negative.
Linda
Ps. As I posted earlier, I was told that her+ bc is usually not BRCA+. Even so, it's not impossible or unwise to be tested.

Karen Weixel · 09-13-2007, 09:40 PM

I am the 12th person on my mom's side to get bc and I still had to pay a portion ($800) of the cost.

karen

Kimberly Lewis · 09-14-2007, 04:54 AM

I guess every one does in a way though. I sought out the geneticist myself. She worked in the cancer center where my Onc was but he certainly didn't think of it and was surprised I tested positive. We are insured through my husbands co. and had to pay $200. of it. Be sure you go to a board certified counselor. There is a website of course...
http://www.abgc.net/english/view.asp?x=1 is the one I found - they have lists of counselors if you have to do it by yourself.

I think after the work up of past family history I had only 16% possibility. So when I was positive even I was surprised. History gets fuzzy real fast though! It was hard to get information. My son was negative, my daughter positive. But now we know and that does help!
Hope this helps....

Stephanie B. · 09-14-2007, 01:26 PM

I don't have a family history, but my onc. ordered the test because I have a daughter and was worried. My insurance picked up 100% of the cost. I have Blue Cross of California-GEM Care. I came back negative by the way. Good luck.

Stephanie B.

harrie · 09-18-2007, 09:36 PM

Yes, 100% payment.

Soccermom · 10-01-2007, 02:26 PM

My insurance paid for testing because I fulfilled many criteria ,personal history of ca,Ashkensi Jewish, multiple ca. within my family (Mom ,3 aunts 2 cousins all BC) and many other types as well.etc.
I suggest that you come to the FORCE (www.facingourrisk.org) website to learn more about BRCA testing and insurance!

Best wishes, marcia

lilyecuadorian · 10-01-2007, 02:34 PM

My Insurance Paid For ..

MCS · 10-01-2007, 06:03 PM

I did it at the beginning of this ordeal. I have two daughters and was concerned. I came out negative for both 1 and 2.

My insurance did pay it. The genetic counselor did say that it may not, and in that case, he would write a letter to support the need. so advise your counselor if it comes back that nothing is covered.

by the way, on visiting my onc this week, he said that there are new test out there to re visit brac 1 and 2, in other words there's more data or genes that can be tested. this would be at the city of hope in Los angeles. but I don't know anything about this

mcs maria

Bev · 10-01-2007, 08:09 PM

Debbie L, Way back in the day, 2 years ago, my insurance company wouldn't tell me if they would cover Herceptin until after I did it.

I filed a claim with the state insurance board. Onc had to write a letter, a few weeks later Ins Co said they would cover with best wishes for successful treatment.So, force the issue. Bev

Soccermom · 10-01-2007, 08:29 PM

MCS, In 2006 Myriad added what is known as the BART panel and then the larger rearrangement panel. If you tested prior to a certain date, they can retest looking at these other areas. This all came about as a result of when Dr Mary Claire King in Seattle ( one of the mutation "founding mothers" so to speak) found mutations that Myriad was missing .she took on families where there was obviously something genetic and feverishly worked to find their answers...

Warmly,Marcia