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Is genetic counseling and testing covered by insurance?
The appointment for cancer risk assessment and counseling is billed to insurance companies as a physician office consultation with Dr. Bomzer, Oncologist. Oncology of Wisconsin accepts most insurance carriers. If you have a question about whether Dr. Bomzer is in your plan, you can contact your insurance company directly or contact us for assistance. At this time, your insurance company will not receive a separate bill for "genetic counseling". You should also check your insurance plan to see if you usually need a referral from your primary care physician.
The cost of testing depends on the test performed and can range from $300-2,800. At your first appointment we will determine if you need genetic testing, which test would be most appropriate and whom in the family is the best person to test first. More and more insurance companies are covering the cost of genetic testing when it is medically indicated. Over 90% of our patients have had genetic testing covered by their health insurance. Many of these patients were initially told it was not a covered benefit. Since these are not routine tests, you may need a letter of medical necessity explaining why the test is needed. We can help you get the test authorized before you go ahead with testing. If your insurance does not cover testing or you choose to pay out of pocket, you might want to ask family members to split the cost of the test. Many families choose this option since it is information that benefits the entire family. Once the underlying mutation is identified in the family, other relatives can be tested for a much smaller charge.
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