Genetic Testing and Insurance
Many insurance companies cover the cost of genetic testing for people who have a personal history and / or a strong family history of cancer. There are state and national laws that protect us from insurance discrimination. Studies have found that insurance discrimination does not happen often.
Many of us are worried about discrimination. Lawmakers are working on newer and better laws that will protect you.
The Hereditary Cancer Program at Cincinnati Children's Hospital Medical Center provides the answers to frequently asked questions about genetic testing and insurance:
Will My Insurance Cover Genetic Counseling Services?
Genetic counseling services may be paid for by your insurance plan or by Medicare or Medicaid.
Your coverage depends on:
- Your medical and family history
- How the test results will affect your health care
- Your particular health care plan
What If I'm Not Covered by Insurance?
There are options for patients who don't have insurance or coverage for genetic testing. A genetic counselor will help you find out about your own insurance coverage for genetic testing or look at other options. For example, some people qualify for research testing, while others may qualify for financial support.
Can I Lose My Health Insurance if I Carry a Cancer Gene?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects people who are part of a group health plan. Group health plans are provided through your employer, union, or professional association. Most people have this form of insurance.
HIPAA states that:
- Genetic information that shows you have an increased health risk CANNOT be used to deny or limit insurance coverage.
- Genetic information CANNOT be considered to be a pre-existing condition.
- You cannot be charged more than other people in the group plan based on your genetic test result.
- HIPAA does not cover people who purchase their own insurance. This includes those who are self-employed and those not insured by their employers.
Do State Laws Provide Any Protection?
Some states, including Ohio, Indiana and Kentucky, have laws to protect patients. State laws also apply to people who purchase their own insurance.
What About Disability and Life Insurance?
There are no laws protecting these types of insurance. Life insurance companies could use genetic test results to determine rates. These companies already ask for your personal and family history information to determine your risk level.
Your genetic counselor can give you more information on HIPAA and on the specific laws that apply in your state.
