by Ashley
This past week I had my annual well woman check-up/exam. Since this is routine preventative care the appointment is covered 100% from my insurance. BUT, something came up during my appointment that probably WILL end up costing me a pretty penny or two.
I just got a new doctor so I don’t know how this has never come up before with any of my other physicians, but when I was filling out my family medical history, my doctor commented on the incidence of cancers in my family. Specifically, my maternal grandmother and maternal grandfather had cancer at relatively young ages (prior to age 50). My grandmother had breast cancer and grandfather had colon cancer – both are known to be heritable. Because of my grandparent’s young ages and the heritability of these diseases, it raised a red flag and my doctor said she’d like run some blood to test for the genetic markers related to these diseases (side note: colon cancer, more common in men, is also related to uterine cancer in women.)
Maybe its just because genetic testing has been improving across recent years but I was kind of surprised no other doctor has ever brought up this possibility before. I decided I would, indeed, like to know whether I carry the genetic marker(s) that make either of these cancers more likely (and, along with these two cancers, several other cancer markers are checked as well). If I test positive for any of these markers then you can take necessary steps (along with more frequent/earlier examinations) to stay healthy. But, obviously, I’m hoping for negatives all around and a big sigh of relief that I don’t have any genetic loading for the most common heritable cancers.
My doctor explained that many insurance companies now cover this testing, at least in part. She said the way the process works is that they get my blood and send to the lab while processing with my insurance. If the out-of-pocket costs of the lab work will end up being $350 or less, they go through and automatically process it. If it will be over $350, they call and inform me of the cost and I can make a decision from there. I was a little shocked that $350 is the “magic number” they choose for informing patients. It still seems rather high and I wish I could provide my own figure (e.g., Give me a call if it will be over $200), but I didn’t get that option. My only option was blood work or no blood work, and given my family history I decided to opt for the blood work.
So right now it’s just a waiting game and I’m crossing my fingers that (1) my insurance will cover the blood work, and (2) the costs are minimal. I have no idea how that will turn out.
If I get the call that it will be over $350, I’m leaning toward declining the tests at this time. I could always have it done again in the future when I’m planning accordingly for this type of expense and can save up. $350 is no chump change!
What would you do? If you had red flags for a genetic predisposition toward certain types of cancer, would you do the genetic testing to find out for sure? How much would you be willing to pay out of pocket for the tests?
PS: Hopefully it comes back negative but – just in case – it’s a good thing I’ve already got my life insurance all wrapped up since genetic loading toward certain cancers would almost certainly pose a problem for getting life insurance for a reasonable rate!!
