Frequently Asked Questions
General Questions
Does HealthyGene accept insurance?
HealthyGene is not currently in-network with any insurance providers, but the genetic testing may be covered (see below). However, we are able to provide you with a superbill (itemized receipt) for our genetic counseling services which you can submit to your insurance for reimbursement. We can not guarantee that you will be reimbursed.
Does insurance cover genetic testing?
Hereditary Cancer
Genetic testing for hereditary cancer is often covered by insurance plans, if you meet certain criteria. These criteria are typically based on your personal and/or family history of cancer. Your genetic counselor will let you know if you meet genetic testing criteria. If your insurance does cover testing, it is still subject to the deductible and any co-insurance required by your plan. Our laboratory partner will contact you if your out-of-pocket cost will be over $100.
Carrier Screening
Carrier screening is often covered by insurance plans. If your insurance does cover testing, it is still subject to the deductible and any co-insurance required by your plan. Our laboratory partner will contact you if your out-of-pocket cost will be over $100.
Proactive Screening
Proactive screening is typically not covered by insurance.
What is the cost of genetic testing?
If you choose not to use insurance or if your insurance does not cover genetic testing, the fee charged by our laboratory partner is typically between $250 and $350.
How is the genetic testing ordered by HealthyGene different from at-home genetic testing?
HealthyGene only orders medical-grade genetic testing from laboratories that are CLIA (Clinical Laboratory Improvement Amendments) certified and CAP (College of American Pathologists) accredited. This means all genetic test results can be used to guide your healthcare decisions. Many other at-home genetic tests should not be used to make healthcare decisions and would require confirmatory testing. Additionally, at-home genetic tests are typically not as comprehensive as medical-grade tests. If you've had at-home genetic testing, additional testing from a medical-grade laboratory may still be recommended.
Are there any laws to protect from insurance discrimination?
Yes, the Genetic Information Non-Discrimination Act (GINA) is a federal law that protects against discrimination from health insurance and employers based on genetic information. However it does not protect against discrimination from life, long-term care, or disability insurance. Click here to learn more about GINA. Additionally, some states have their own laws to protect genetic information from insurance discrimination and privacy issues.
Hereditary Cancer
What are some examples of hereditary cancer conditions?
Two of the most common hereditary cancer conditions are Hereditary Breast and Ovarian Cancer (HBOC) and Lynch Syndrome. HBOC is caused by gene mutations in the BRCA1 or BRCA2 genes and leads to an increased risk for breast and ovarian cancer in females. Males also have an increased risk for prostate and male breast cancer. There is also an increased risk for pancreatic cancer. Lynch Syndrome is caused by gene mutations in the MLH1, MSH2, MSH6, or PMS2 genes. The most common cancers seen in Lynch syndrome are colon and uterine.
How can genetic testing change my healthcare decisions?
If you test positive for a cancer gene mutation, it means you have an increased risk to develop certain types of cancer. Because of this increased risk, more frequent cancer screening starting at an earlier age is typically recommended. For example, for females found to have an increased risk for breast cancer, recommendations often include getting both an annual mammogram and a breast MRI every year (one test every 6 months). Screening for breast cancer starts at age 25, compared to age 40 for the general population. Additionally, some people choose to have their breasts removed before they develop cancer to reduce their cancer risk as much as possible.
What genetic testing will my HealthyGene genetic counselor recommend?
The genetic testing recommended by your HealthyGene genetic counselor will depend on your personal and family cancer history as well as your personal preferences. Most commonly, cancer genetic testing includes a panel of genes. Panels can include anywhere from 2 to 90-some genes.
I had genetic testing previously, do I need updated testing?
Maybe. It depends on what was tested previously and when it was done. Our knowledge of gene-disease associations and genetic testing technology itself has improved over the years. Additional genes may be available that you were not tested for previously, or new ways to test the genes you were already tested for may be available now. Your HealthyGene genetic counselor will be able to let you know if updated testing is an option for you, if you provide them with your previous genetic test report.
Can my doctor order testing for me?
Yes, doctors are able to place orders for genetic testing. However, most doctors do not feel they have expertise in genetics and may not order testing for all of the genes that should be tested. A HealthyGene genetic counselor will tailor the genetic test ordered based on your personal and family cancer history and will ensure all relevant genes are included. Additionally, working with a HealthyGene genetic counselor ensures that you go into genetic testing fully informed. If you test positive for a gene mutation, you are already working with an expert who can connect you with the correct resources quickly.
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Carrier Screening
What are some examples of the inherited genetic conditions included on carrier screening?
Two of the most common recessive conditions are cystic fibrosis and spinal muscular atrophy (SMA). Cystic fibrosis is a genetic condition that effects the lungs and digestive system. Individuals typically have frequently lung infections requiring hospitalization. Complications from the disease can lead to the need for lung transplants and may lead to early death, however treatments are improving outcomes for individuals with cystic fibrosis.
SMA is a serious inherited condition that leads to progressive muscle weakness, loss of motor skills, and increased difficulty breathing. In the most common form of SMA, symptom onset typically begins within the first 6 months of life and can be fatal by age 2. New treatment options are available which can improve symptoms, but there is currently no cure.
What genetic testing will my HealthyGene genetic counselor recommend?
Typically, carrier screening includes a panel of genes. Panels can include anywhere from 4 to hundreds of genes, depending on your preferences. A HealthyGene genetic counselor can discuss the benefits and drawbacks of each testing option with you.
What happens if I am a carrier of a genetic condition?
It is very common to be a carrier of a genetic condition. If you are found to be a carrier, the next step is typically for your partner to have carrier screening to determine if they are a carrier for the same genetic condition.
I had genetic testing previously, do I need updated testing?
Maybe. It depends on what was tested previously. Our knowledge of gene-disease associations and genetic testing technology itself has improved over the years. Additional genes may be available that you weren't tested for previously, or new ways to test the genes you were already tested for may be available now. Your HealthyGene genetic counselor will be able to let you know if updated testing is an option for you, if you provide them with your previous genetic test report.
Can my doctor order carrier screening for me?
Yes, doctors are able to place orders for carrier screening. However, most doctors do not feel they have expertise in genetics and may not order testing for all of the genes that are available. A HealthyGene genetic counselor will take a full family history to ensure all appropriate genes are included on your carrier screening, and may make recommendations for additional genetic testing based on your personal and family health history. Additionally, working with a HealthyGene genetic counselor ensures that you go into genetic testing fully informed. If you are found to be a carrier, you are already working with an expert who can facilitate carrier testing for your partner and connect you with the correct resources quickly.
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