So, here's a quick rundown of the situation: My wife and I are expecting kid #3 next February. My wife is over age 35, so her doctor recommended that she undergo pre-natal genetic testing to screen for Down Syndrome, plus a host of other genetic abnormalities. Her doc told her that it's a simple blood test, usually covered 100% by insurance plans.
Before she agreed to the test, I contacted our insurance company to ask if they covered pre-natal genetic testing. Yes, they did, but since we're on a high-deductible plan, our deductible will apply. Okay, no problem.
A couple weeks ago, my wife had the blood draw. We haven't heard any results yet, but the claim did show up on my insurer's website, and I saw the Explanation of Benefits. I also saw a horrifying number in the "what you can expect to pay" category: $5,750.
Basically, the genetic testing company, Natera, billed my insurer $8,000. My insurer paid them nothing, $750 goes toward the deductible, and an additional $5,000 screening test was not covered and therefore passed along to us. Apparently, Natera did a screening for genetic microdeletions, which I had never heard of, and which my insurer does not cover at all. There was no way for us to know beforehand that 1) Natera would screen for microdeletions, and 2) my insurer would not cover that particular test.
If we had all this to do again, I don't think we would choose to do the pre-natal genetic testing considering how much we might have to pay out of pocket. Right now, I'm waiting to hear what Natera says. Maybe they'll just eat the cost of that test and bill us the remaining $750. Ha, right.
Any advice for this situation? Searching reveals similar tales from others who have had genetic testing not covered by insurance, but I'm having trouble finding follow-ups. I'm bracing myself for a huge bill, but I've never been in a situation like this before, and I can't believe that this one blood draw might cost us $5,750. Should I bother reaching out to Natera before we get a bill, or should we just wait to see what happens?
I'm not even sure who's supposed to by my ally here: the genetic testing company, my insurer, or my wife's doctor? Maybe none of the above. Any advice is certainly appreciated.
Submitted September 10, 2017 at 02:13PM by EuridiceSequens http://ift.tt/2gVq7qg
