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Monday, September 1, 2014
Genetic Tests and Insurance Companies
I would like to get genetic test for breast cancer. My, mother, her sister, and my cousin from that sister (who was only 36), all have breast cancer. My mother`s other sister had cervical cancer. If I got a genetic test, would my health insurance company get the results, and if so, can a positive result deny any future coverage, should I need treatment, or want switch companies? Thank You.
Genetic testing for Hereditary Breast/Ovarian Cancer Syndrome is not appropriate for everyone. Your family would benefit from genetic counseling to determine your risk of having the Syndrome and to discuss testing in more detail. The best initial person to test in a family is a person who has had cancer themselves. As such, your cousin is the most appropriate person to have testing in the family. If she is found to have a genetic change, then you could consider testing. A genetic counseling professional in your area can be found by using the National Cancer Institute`s website (CancerNet).
[Your aunt`s cervical cancer is not likely to be related to the breast cancer found in your other family members.]
If you ask your insurance company to pay for the test, they have the right to check your records. The federal Health Insurance Portability Act of 1996 states that a presymptomatic genetic condition (such as testing positive for the gene for Hereditary Breast/Ovarian Cancer Syndrome but not yet having cancer yourself) cannot be considered a pre-existing condition if you switch companies in the future. This protection is for participants in large health plans however and does not protect you as much if you hold an individual policy. All these issues would be discussed with you in more detail when genetic counseling is given and before any testing would be performed.
Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University