Insurance Coverage

Many insurance policies will cover genetic testing for hereditary breast and ovarian cancer. When you test with DNA Direct, our lab will work with you to secure reimbursement.

How It Works
Insurance Coverage
Anonymity
Insurance Company Websites

How It Works

When you order a test online with DNA Direct, you will be asked whether you would like insurance coverage. If you answer "yes," you will receive an insurance reimbursement form in your test kit. Fill out this form and send it in with your sample. Sample Reimbursement Form (.PDF)

If you seek insurance coverage, you will have two options :

  1. To start the lab processing of your test immediately, and agree to cover any costs that your insurance will not cover.
  2. To delay the lab processing of your test until you know how much your insurance will reimburse. Then you can make the decision whether to go ahead with testing, if cost is an issue for you. If you choose this option, it can can take a few weeks to a few months to receive reimbursement confirmation from your insurance company.

Documentation Requirements. Depending on your insurance company's policies, you may need documentation from your doctor and/or DNA Direct's ordering physician. Some policies require a three-generation family medical history, which DNA Direct will provide for you. Some require that you have a family member with a hereditary breast/ovarian cancer mutation, or that you provide a letter of medical necessity from your personal doctor. Sample Letter of Medical Necessity (.PDF)

Insurance Coverage

Insurance policies usually cover testing according to medical necessity. Most policies will cover testing if:

  • You have a known hereditary breast/ovarian cancer mutation in your family.
  • You are of Ashkenazi Jewish (Eastern European) ancestry and have or have had breast or ovarian cancer.
  • You have had breast cancer under age 50.
  • You have had ovarian cancer at any age.
  • You are a man who has had breast cancer.
  • You have a family history consistent with hereditary breast/ovarian cancer.

Average Costs. In most cases, if you meet these criteria, insurance will cover 80 to 90 percent of the laborabory and testing costs. It may not cover DNA Direct's interpretation and counseling fees.

Anonymity

Some of our customers prefer to test through DNA Direct and not use insurance, in order to keep their testing and test results off their medical record. DNA Direct's secure system separates billing and clinical information, so the testing lab only sees your Order ID, not your name. We do not share your information with any third party without your written permission.

Insurance Company Websites

Learn more about testing with our pre-test questionnaire: Start Questionnaire