Medicare covers genetic testing for people with a cancer diagnosis who meet certain criteria. Certain health issues and medical conditions are hereditary, which means that genetic testing can reveal markers and signs of these issues before symptoms arise. This is not a complete listing of plans available in your service area.
An individual with a personal history of breast cancer and one or more of the following: Diagnosis before the age of 45 with or without a family history, Diagnosis before the age of 50 or two breast primaries, with at least one close blood relative with breast cancer diagnosed before 50, or at least one close blood relative with ovarian cancer/fallopian tube/primary peritoneal cancer, Two breast primaries when first breast cancer diagnosis occurred prior to age 50, Diagnosis at any age, with at least two close blood relatives with breast and/or epithelial ovarian/fallopian tube/primary peritoneal cancer, A close male blood relative with breast cancer, A personal history of epithelial ovarian/fallopian tube/primary peritoneal cancer, Of an ethnicity associated with higher mutation frequency (e.g., Ashkenazi Jewish); no additional family history required, Individuals with a first-degree relative with known mutation, Individuals meeting either the revised Bethesda guidelines or Amsterdam Criteria (see table below), Individuals diagnosed with endometrial cancer under age 50. Other tests may require a blood sample, which may mean a patient experiences common side effects related to blood being drawn. | 2019-2020 Medigap Plan Benefits, You were diagnosed at or before age 45, with or without a family history of the disease, You have had two breast primaries when the first cancer diagnosis came before age 50, You have had a personal history of epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer, You have a close male blood relative with a history of breast cancer, You are of an ethnicity with higher mutation frequency, You have a close blood relative with a  BRCA1 or BRCA2 gene mutation. A genetic test can confirm or rule out an appropriate diagnosis. What is the Medicare Annual Election Period (AEP)? Cancer is the leading cause of death worldwide and impacts millions of patients and families each year. Diagnostic, predictive or presymptomatic. Medicare guidelines also have a list of requirements for genetic testing for the BRCA1 or BRCA2 gene mutations, which are linked to breast cancer, under certain circumstances. In 2020, Medicare will cover genetic testing if: How much does the BRCA test cost? Today, Drew's focus is on developing our marketing and telesales sectors. We help individuals nationwide with Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Extra Help, and Final Expense. The testing kits analyze over 30 genes that can contribute to the most common hereditary cancers. A male with a personal history of male breast cancer. What do I do? However, an individual can now switch to a Marketplace plan during open enrollment and immediately get coverage for the preexisting conditions. Researchers have found mutations in more than 50 hereditary cancer syndromes. Testing for Lynch syndrome in people diagnosed with cancer begins with tumor testing. Because human DNA is so complex, the development of genetic tests is ongoing and new discoveries of how to apply testing to the diagnosis and treatment of disease are made frequently. I have a mutation and cancer. Learn more about these exceptions below. hereditary non-polyposis colorectal cancer, Lynch Syndrome) gene analysis; full sequence, 81301   Microsatellite instability analysis (.e. Plus, knowing about an inherited mutation gives you the power to take the necessary steps to reduce your risk of cancer or to help detect it at an early stage.

If you decide to use a Medicare cancer test kit to screen for covered screenings, be sure to follow the test’s directions to the letter.
For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. Medicare Advantage plans that offer extra benefits may extend the types of genetic tests covered, but these additional benefits vary from plan to plan. Medicare may cover BRCA testing for people diagnosed with any of the following cancers: Some regions require one of the above combined with family history of specific cancers and/or Ashkenazi Jewish ancestry. Thinking about cancer or dealing with cancer risk can be scary or overwhelming, but we believe that receiving information and resources is comforting, empowering, and lifesaving. Broader coverage is available under Noridian Healthcare Solutions, Palmetto, Wisconsin Physicians Service Insurance, and CGS Administrators. An adopted person or a person with little known family health history, who comes from a small family, or who has few female relatives: breast or ovarian cancer diagnosed at or before age 45, triple negative breast cancer diagnosed at or before age 60. a personal history of another cancer that is suspicious of being a BRCA-related cancer. Kits often include a saliva collection kit and a prepaid return label. What Do Medicare Parts A and B (Original Medicare) Cover? I also agree that by submitting this Contact Request form, I am bound by Medicare Health Benefits, LLC Privacy Policy and Terms of Use.