Paying for Your Test

Genetic testing is more affordable than it’s ever been. As testing becomes a common way for individuals to proactively inform decisions about their health, insurers are adjusting their policies to make the process more accessible and less costly. Many labs are jumping on board too, working to create more affordable options.

The Cost of Genetic Testing

A lot of factors go into determining the cost of each test, including the specific test the lab runs, the number of genes tested and the lab’s specific business model. If you look for published test prices, you’ll see prices ranging from a few hundred dollars up to several thousand dollars. But remember, once you factor in your health insurance and any other financial resources that are available to you, the price you actually pay will most likely go down. To get a better idea of what your specific test will cost, you can always check with the lab.

Using Health Insurance to Pay

If you’ll be using insurance to pay – or help pay – for genetic testing, start the process by talking to your healthcare provider or a genetic counselor. Chances are, your insurance company will require you to start there anyway. And your healthcare provider or genetic counselor may prefer working with a specific lab.

It’s also a good idea to check your health insurance policy for details about any copays, deductibles, or coinsurance that will affect what you end up having to pay. The bright side? If you meet the criteria, there’s a good chance your plan will cover testing with very low or no out-of-pocket expenses. And if you have a significant family health history, the Affordable Care Act guarantees you access to genetic counseling and testing for BRCA1 and BRCA2 mutations at no cost to you.

A couple other things to remember if you’re going through insurance:

  • It’s illegal for a health insurance company to deny you coverage or change your premium based on your test results.
  • If your insurer won’t cover your genetic testing, you have the right to appeal the decision.
“I feel like I have spent so much time on the phone with my insurance just understanding my deductible and what my out of pocket costs are. I’ve never had to think about how my insurance works and what I should be saving in my medical savings account and how it all works together. I’m not a numbers person so it was very tough to navigate.”

Paying On Your Own

If you don’t have insurance – or decide not go through your insurer – you can consider paying for testing yourself. Some labs are offering direct payment options with simple, affordable pricing starting around $250 – without the need for insurance. More and more, payment options are being introduced designed especially for women who want or need to pay on their own.

Cost Shouldn’t Stop You

If you want to get genetic testing, cost doesn’t have to be a barrier. Many health insurance plans offer testing with low out-of- pocket expenses and, for women who are uninsured, there are a variety of financial assistance programs available. There are also low-cost options for women who want to bypass insurance completely.

If you meet certain criteria, research studies may cover all of your genetic testing costs. Talk to your healthcare provider or genetic counselor to see you qualify for any current studies.