Billing Beat

BRCA genetic testing

September 24, 2013

United Healthcare covers BRCA genetic counseling and evaluation for BRCA testing today without cost-share as recommended by the current U.S. Preventive Services Task Force (USPSTF) and listed in the Preventive Care Services Coverage Determination Guideline. In April 2013, the USPSTF released a draft recommending the BRCA test for women over age 18 without a cancer history who may be at increased risk for BRCA-related cancer, as defined by their family history, nationality or other factors. In response to the USPSTF draft recommendation, United Healthcare will cover the BRCA test without cost-share beginning Oct. 1, 2013 for women over age 18 at risk for BRCA-related cancer and who have not been diagnosed with breast or ovarian cancer, subject to prior authorization. The test will be covered in full with prior authorization. As before, United Healthcare will continue covering BRCA testing for women and men at risk with a history of cancer who meet other testing guidelines as provided by their benefit plan. United Healthcare strongly recommends that women who believe that they should have the BRCA test done obtain genetic counseling.

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