Will my insurance pay for genetic counseling?
Most insurance companies cover part, if not all, of the office visit charges. We strongly recommend that you check with your insurance policy to see if you require a referral from your primary care physician. Referrals should be made out to Joseph Tucker, M.D. Initial consults are typically billed under the code 99403, and it may be helpful for your insurance company to know this to give you a proper estimate.
Will my insurance pay for genetic testing?
It is important to note that genetic testing is a separate charge from genetic counseling. At the end of the first appointment we will determine if you are an appropriate candidate for genetic testing, which test would be most appropriate, and which family member (ideally) should be tested first. We will discuss the cost of that testing with you. Most insurance plans cover all or a majority of the cost when there is a reasonable risk of a hereditary cancer syndrome. In recent years, the cost of genetic testing has dropped dramatically, and most patients can be tested for $250 or less.
What if my insurance company learns I have had genetic counseling or testing?
Many patients express concerns about discrimination by health and life insurance companies. Federal legislation provides protection against genetic discrimination by health insurers and employers. The federal laws in question are called GINA (Genetic Information Nondiscrimination Act) and the ACA (Affordable Care Act).
What information should I bring to my first counseling session?
When we take a family history, we will ask about your brothers, sisters, parents, aunts, uncles, cousins, and grandparents. We will ask for their ages (whether or not they have had cancer). If a relative has had cancer, we will ask about their age at diagnosis and how it was treated. If possible, medical records or death certificates are very helpful. If a relative has had genetic testing, it is extremely important to bring a copy of the laboratory result. While they may or may not be consulted, please feel free to bring relevant medical records such as pathology or colonoscopy reports.
Can I just have genetic testing without counseling?
No. The genetic counseling and risk assessment is an important part of the testing process. The entire process is necessary for correct interpretation of test results and subsequent management options. Some insurance companies will not cover genetic testing unless counseling is performed first.
What does this test do?
The genetic tests that are ordered through our program are performed on a blood draw or a saliva sample. The laboratory extracts your genes, which are made up of DNA, from your sample, and focuses on the genes associated with stopping cancer. We are not looking to see if you “have” the genes, the question is whether your genes are capable of doing their job, which in this case is to defend your body against cancer. This test can come back one of three ways:
- Positive: We have found a mutation (change) in one or more of your genes that we know is associated with an increased risk for cancer. In this case, we would discuss what this means for you and what screening and prevention tools are available and recommended.
- Negative: After analyzing your genes, we did not find any changes, or the changes that were found are not associated with an increased risk for cancer.
- Variant of Uncertain Significance (VUS): This label is used when a change is found, but the lab is unsure whether the alteration (variant) is enough to increase the chance for cancer. Based on the data we have seen, the large majority of these changes are eventually reclassified as negative. The VUS designation is used to show that the lab is unsure but will continue to monitor the change and reclassify as soon as sufficient data are available. Individual cancer screening recommendations are based on personal and family medical history.
How will this information benefit me?
People with a family history of cancer often worry about themselves or their children’s risk for developing cancer. Our goal is to provide individual risk assessment that can be incorporated into your ongoing medical care.
Some patients are reassured to learn that their own cancer risk is lower than expected. For individuals who are found to be at high risk, their physician may suggest careful observation and screening. Early detection is extremely important.