MedHelp.org will cease operations on May 31, 2024. It has been our pleasure to join you on your health journey for the past 30 years. For more info, click here.
Avatar universal

Did your Insurance cover the genetic testing of your biopsy?

I have Aetna and my 'indeterminate' pathology sample has been sent away for gene testing; I have Aetna, and though their payer policy states it is covered if criteria is met, I'm looking for some idea of how often they pay/don't pay and what the cost ended up being when they did not. Thanks! Lisa
1 Responses
Sort by: Helpful Oldest Newest
Avatar universal
My insurance did not cover genetic testing, but I did not end up paying anything.  I don't know if there are other companies doing genetic testing for thyroid cancer than the Afirma/Veracyte, but that is what I used.

Even if you have insurance, if your insurance will not pay for the testing, and your income is under a certain level (I think it was income under 100K a year, but I could be off with that amount, this was 3 years ago for me), you can qualify for the Veracyte Access Program.  That's what I used and I ended up not having to pay anything.  If I'm recalling correctly, it was very easy to apply for the Veracyte Access Program, but I had to contact them using an email address on the website to apply for it.  I think maybe I had to mail in a tax return to verify I qualified.

It is beneficial to insurance companies to cover the genetic testing since if the test comes back benign, they will save a lot of money by not having to pay for an unnecessary thyroid surgery.  Hopefully your insurance will cover it.  Aetna is listed as an In-Network insurance plan on the Afirma website (but I know how that goes - my in-network hospital for my in-network thyroid surgery somehow had out-of-network pathology department that I then had to get them to approve).

If your insurance doesn't pay and you don't qualify for Veracyte Access Program, it looks like it costs around $4800 now.  But, I think it is likely that your insurance will pay for the test.
Helpful - 0

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
Avatar universal
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.