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Nic1229
LIF Adolescent
Member since 5/13 639 total posts
Name:
Nicole
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Genetic Testing
My DD is only 13 months so it wasn't too long ago that I was pregnant. I have several friends who are pregnant now though and every single one of them have had genetic testing at 12 weeks.. None of them are over 35.. Only 1 is even over 30. Is this something new that all doctors are ordering? Does insurance cover it???
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Posted 7/2/15 9:32 PM  |
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ChristinaM128
LIF Adult
Member since 8/12 4043 total posts
Name:
Christina
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Re: Genetic Testing
What sort of testing are you referring to? I think everyone gets the "genetic testing" at the first appt. to look for certain genetic disorders (especially based on your nationality of origin), and then the finger prick in conjunction with nuchal fold testing at 12 weeks.
Are you referring to the genetic testing where they look for baby's DNA from mothers blood (like materna21 and a few other companies out there)? I had it done b/c I am over 35, but my doctors made it a point to tell me that it's something they just recommend for 35+, and they even made sure my insurance covers it because some don't if you're only 36.
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| Posted 7/2/15 9:58 PM |
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Nic1229
LIF Adolescent
Member since 5/13 639 total posts
Name:
Nicole
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Re: Genetic Testing
Posted by ChristinaM128
What sort of testing are you referring to? I think everyone gets the "genetic testing" at the first appt. to look for certain genetic disorders (especially based on your nationality of origin), and then the finger prick in conjunction with nuchal fold testing at 12 weeks.
Are you referring to the genetic testing where they look for baby's DNA from mothers blood (like materna21 and a few other companies out there)? I had it done b/c I am over 35, but my doctors made it a point to tell me that it's something they just recommend for 35+, and they even made sure my insurance covers it because some don't if you're only 36.
Sorry.. yes I meant the testing similar to maternt21.. i think there are 2 other companies.. 5 coworkers sitting at lunch talking and all have had it.. so I text my 2 pregnant friends to ask- both have had it too..
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| Posted 7/2/15 10:14 PM |
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ChristinaM128
LIF Adult
Member since 8/12 4043 total posts
Name:
Christina
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Re: Genetic Testing
I'm curious to hear what others say about this!
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| Posted 7/2/15 11:43 PM |
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alexb
LIF Adult
Member since 5/13 960 total posts
Name:
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Genetic Testing
Im 33 years old and recently had this test done. I questioned multiple times whether this was covered by insurance as i had read that it might not be. The nurse said that the test was recently passed to be given to all patients/covered by insurance. Now i am receiving appeal letters from Aetna so i have no idea if it is truly covered or not:\
Message edited 7/3/2015 3:33:38 AM.
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| Posted 7/3/15 3:33 AM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Genetic Testing
At 12 weeks no matter what the age of the mother we order a NT Scan followed by the AFP around 15/16 weeks. As far as the materniti21 and other testing a lot of moms under 35 are requesting it more to find out the sex a whole lot sooner. Pending on insurance it may not cover because when we request the test it depends on how it gets coded. For example if you're 28 no issues or history of downs or anything in the family we won't code it as "high risk" and it's up to your insurance. For moms over 35 even with no family history we consider high risk due to maternal age and more likely your insurance will cover it.
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| Posted 7/3/15 5:58 AM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: Genetic Testing
Posted by alexb
Im 33 years old and recently had this test done. I questioned multiple times whether this was covered by insurance as i had read that it might not be. The nurse said that the test was recently passed to be given to all patients/covered by insurance. Now i am receiving appeal letters from Aetna so i have no idea if it is truly covered or not:\
Not true as far as it being covered by all insurance. It all depends on the coding once submitted and if your insurance sees it more elective than "mandatory" they wont cover and Aetna is one of the toughest(everything by the book).
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| Posted 7/3/15 6:01 AM |
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Nic1229
LIF Adolescent
Member since 5/13 639 total posts
Name:
Nicole
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Re: Genetic Testing
Posted by TyReseGreen
At 12 weeks no matter what the age of the mother we order a NT Scan followed by the AFP around 15/16 weeks. As far as the materniti21 and other testing a lot of moms under 35 are requesting it more to find out the sex a whole lot sooner. Pending on insurance it may not cover because when we request the test it depends on how it gets coded. For example if you're 28 no issues or history of downs or anything in the family we won't code it as "high risk" and it's up to your insurance. For moms over 35 even with no family history we consider high risk due to maternal age and more likely your insurance will cover it.
Does empire the NYS Health Insurance Plan usually cover it ? Maybe that's why they all had the test because all my coworkers have that same insurance.
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| Posted 7/3/15 7:40 AM |
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alexb
LIF Adult
Member since 5/13 960 total posts
Name:
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Re: Genetic Testing
Posted by TyReseGreen
Posted by alexb
Im 33 years old and recently had this test done. I questioned multiple times whether this was covered by insurance as i had read that it might not be. The nurse said that the test was recently passed to be given to all patients/covered by insurance. Now i am receiving appeal letters from Aetna so i have no idea if it is truly covered or not:\
Not true as far as it being covered by all insurance. It all depends on the coding once submitted and if your insurance sees it more elective than "mandatory" they wont cover and Aetna is one of the toughest(everything by the book).
Ugh, i hope i dont get screwed bc i literally asked like 10 times whether or not it was covered. I would be so pissed if they give me a bill.
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| Posted 7/3/15 8:31 AM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Genetic Testing
I'm over 35 and when I had it done I ended up with a huge bill but I didn't meet my deductible for the year so my OOP was $1400. After that I was fine as far as my deductible though. Lol
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| Posted 7/3/15 8:59 AM |
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TyReseGreen
Lil Prince is here
Member since 8/11 6338 total posts
Name:
Theresa
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Re: Genetic Testing
Posted by Nic1229
Posted by TyReseGreen
At 12 weeks no matter what the age of the mother we order a NT Scan followed by the AFP around 15/16 weeks. As far as the materniti21 and other testing a lot of moms under 35 are requesting it more to find out the sex a whole lot sooner. Pending on insurance it may not cover because when we request the test it depends on how it gets coded. For example if you're 28 no issues or history of downs or anything in the family we won't code it as "high risk" and it's up to your insurance. For moms over 35 even with no family history we consider high risk due to maternal age and more likely your insurance will cover it.
Does empire the NYS Health Insurance Plan usually cover it ? Maybe that's why they all had the test because all my coworkers have that same insurance.
Through the state they cover almost everything so that may be why. I wish I had that coverage 
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| Posted 7/3/15 9:00 AM |
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MrsS1231
LIF Toddler
Member since 1/15 495 total posts
Name:
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Genetic Testing
Did you ask the insurance co or the doctors office? If it was the office I would call the ins co.
I'm over 35 and my insurance said that it's a case by case basis and that my dr would have to submit for an approval.
The girl that works at the office is a dumbass and never gave the dr the info I emailed her so I decided against it.
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| Posted 7/3/15 10:46 AM |
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NYCGirl80
I love my kiddies!
Member since 5/11 10413 total posts
Name:
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Re: Genetic Testing
i was over 35 so I had it done with my second pregnancy. If I wasn't over 35, it would have cost me $13k+ OOP because insurance would not have covered it. Definitely would not have had it done in that case.
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| Posted 7/3/15 1:13 PM |
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LuckyStar
LIF Adult
Member since 7/14 7274 total posts
Name:
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Genetic Testing
I asked for it and my OB told me no because it wouldn't be covered and I'm not high risk for genetic diseases. I'm 30.
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| Posted 7/3/15 6:14 PM |
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wishing2012
My heart is full
Member since 3/12 1961 total posts
Name:
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Re: Genetic Testing
I didn't get it with my first, or even know about it. For this pregnancy, my OB said I qualify because I'll be giving birth at 35. I'm still calling my insurance to double check that it will be covered. I definitely don't want any surprise bills!
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| Posted 7/3/15 8:15 PM |
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Jenn79
One more?
Member since 2/12 2410 total posts
Name:
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Re: Genetic Testing
My sister just got it done. Her doctor told her it's being offered for free for a limited time. The dr said everyone's doing it. I'm thinking it's probably for some kind of study
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| Posted 7/3/15 8:41 PM |
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mattsgirl1013
LIF Adolescent
Member since 11/13 683 total posts
Name:
Jessica
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Genetic Testing
My doctor offered it to me when I was pregnant with DS (he was born in January). I was 28 when I got pregnant with the history of problems. He told me that it should be covered and that if I got a bill, they would deal with the company.
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| Posted 7/3/15 9:59 PM |
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SummerMom
Now a mom of 2!
Member since 6/07 4970 total posts
Name:
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Re: Genetic Testing
Posted by Nic1229
Posted by TyReseGreen
At 12 weeks no matter what the age of the mother we order a NT Scan followed by the AFP around 15/16 weeks. As far as the materniti21 and other testing a lot of moms under 35 are requesting it more to find out the sex a whole lot sooner. Pending on insurance it may not cover because when we request the test it depends on how it gets coded. For example if you're 28 no issues or history of downs or anything in the family we won't code it as "high risk" and it's up to your insurance. For moms over 35 even with no family history we consider high risk due to maternal age and more likely your insurance will cover it.
Does empire the NYS Health Insurance Plan usually cover it ? Maybe that's why they all had the test because all my coworkers have that same insurance.
Depends on the brand of test your particular doctor orders. I'm over 35 and have a very long history of losses (with documented genetic abnormalities) and my OB told me that my MaterniT-21 would be covered. Nope. My NYS Health Insurance (Empire - I'm a teacher) stopped covering it in December. I got hit with a bill for over $2000. I was able to call them and appeal for "financial hardship" and get it knocked down to $200. I was fine with paying $200 to find out that all was well with Baby, but it was quite a shock to have been told that it would be free and then get that bill in the mail.
A friend of mine at work who is 35 and has no history of losses got her test at a different office and her OB ordered a different brand - Panorama, I think? She got her test done a week after mine and it was 100% covered. So Empire seems to just have a problem with MaterniT-21.
Message edited 7/4/2015 2:47:28 PM.
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| Posted 7/4/15 2:46 PM |
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