I really dont understand this country

I scheduled my annual wellness checkup, did the usual blood work, and answered some questions. They suggested I get genetic cancer counseling because of my family history.

I asked, “Is this covered by insurance? How much will it cost?”

The answer was, “No idea. You’ll need to call the cancer center or your insurance.”

So, I called the cancer center. They told me I could ask my insurance or check with their finance department, but they only check costs after you book an appointment.

I then called my insurance, got transferred four times, and was told I needed to confirm if my doctor and the facility are in-network. I didn’t know how, so I asked them to check. After double-checking, they confirmed the cancer center is covered.

They then asked if my referral was for:

  • Genetic Testing
  • Non-routine Genetic Counseling
  • Routine Genetic Counseling

I said I didn’t know the difference and offered to send my referral. She said she couldn’t explain the difference because I’m not medically trained. She told me routine, medically necessary testing is covered 100%, but genetic testing and non-routine counseling aren’t; they count toward my high deductible. But since we don’t know which one my appointment is for, I had to call the cancer center again.

I booked the appointment at the cancer center. They transferred me to the finance department to discuss costs. I asked for a price quote.

They said they couldn’t tell me if it was covered because they didn’t know what type of counseling I was getting. I currently have a new patient consult scheduled, not the test, so they can’t tell which test yet. They suggested I talk to my doctor. I told them my doctor referred me. Then they asked me to speak directly with the office where I have the appointment. I’m not sure what the finance department’s purpose is at this point.

I contacted the office and asked what’s covered by insurance. They checked my appointment and said coverage depends on my benefits, which they’ll run after the appointment. I said I’d like to know the price beforehand in case it’s very high. I didn’t get a clear answer. She mentioned it’s a standard consult visit, a specialist visit.

I asked if they knew if I was referred for genetic testing, non-routine genetic counseling, or routine genetic counseling. She said it’s “most likely” routine genetic counseling. I asked how we could confirm this. She said we’d only know the type of genetic testing after the visit. I asked how much the first counseling visit would cost out of pocket—$350. Follow-up visits are $150. But I won’t know what kind of genetic testing is needed (or if it’s covered) until after the counseling.

This process is frustrating. Why can’t the department that schedules appointments take your insurance and tell you the costs upfront? I still don’t know the total costs.

5 Likes

You can make the appointment, and then you should be able to get the billing code once a specific test is ordered.

Have you confirmed that this center is in your network? That’s crucial.

With the billing code, you might get an idea of the test cost. You can call your insurance company to check.

There are also knowledgeable billers on this subreddit. If you post the specific billing code, they might give you a better idea of the cost.

With a high deductible plan, expect to owe a lot—that’s almost certain. Even if it’s “covered,” it will go toward your high deductible, and the “negotiated” rate at an in-network facility will still be pricey.

6 Likes

So, you need to see a specialist first.

You know the cost of that visit.

Based on that visit, the specialist will decide if any tests are needed.

I strongly suggest you don’t do anything else until you talk to the specialist. You’ll want to know what they recommend, what the costs are, and what your insurance might cover.

Also, while I don’t think Dr. Google can replace a real doctor, I like to research my condition or reason for the visit. This helps me ask better questions and get the most out of the appointment. I’m not there to second-guess the recommendations, just to understand them better as a layperson.

5 Likes

Yes, they confirmed the center is in-network. I won’t have a billing code for the genetic test until after the consult, which they said is just a specialist visit. I’ll pay $350 out of pocket for that. Once I get the billing code, I’ll send it over and ask here. Thanks!

4 Likes

I totally relate.

I’m confident and assertive when it comes to making calls and handling adult responsibilities. I manage most of my family’s appointments and benefits. I’m 37, so I’ve been doing this for about 20 years. I also worked as a public health communicator for five years and have been in health tech ever since, so I’m pretty familiar with health terminology.

But our healthcare system is unbelievably confusing.

It’s so frustrating that sometimes it brings me to tears or makes me furious, especially when dealing with support reps who aren’t equipped to help navigate the system.

It shouldn’t be this hard for a college-educated adult with 20 years of experience to get care and use their benefits.

4 Likes

That’s why I ended up canceling my appointment. I don’t have the energy or patience for it. Stress is a leading cause of cancer, so I cut out the stress and improved my odds instantly!

3 Likes

I understand your frustration.

To navigate the bureaucracy, here’s what you need to do:

First, call the genetic counseling center’s billing department. Ask them for the service code they’ll use to bill for your initial counseling visit with the specialist.

Next, ask for the provider’s NPI number (either the doctor’s or the facility’s).

With those two numbers, call your insurance claims department. The frontline reps might not know, so ask to speak to someone in claims. Find out the negotiated reimbursement rate for that service code with that provider’s NPI. If they don’t know, ask for a supervisor.

They should tell you the negotiated rate and what your portion will be. Genetic counseling is usually covered, but the key is whether it applies to your deductible or not.

Alternatively, check if your insurance company has a cost estimator tool on their website. If they do, log into your portal to see the estimate for genetic counseling.

2 Likes

Just a heads up: The only genetic testing I’ve seen covered is BRCA. Not saying it’s the only one, but just FYI.

Also, most genetic testing labs are out-of-network and charge a lot—like $2K to $5K, depending on the situation. However, they often offer a much lower cash or non-insurance option (around $200 to $1,200).

So, definitely ask who will be doing the testing and call them first if you decide to go that route.

Good luck!

Edit: It’s also worth asking what your insurance might cover if you’re confirmed as high risk. This doesn’t always mean you need genetic testing. For example, I know a high-risk breast cancer patient in her 30s. Her insurance covers a mammogram and MRI annually, even though she doesn’t have the BRCA gene, but she has good insurance.

1 Like

It’s weird it shows on my insurance under “preventative” and I was told the routine kind would be covered 100% for 3 tests.

They’re going to be extremely disappointed with the train service.