One of the latest adds another "free" screening to the list of preventive tests that will be made available at no (direct) charge to the consumer.
How many free $3000 tests can be performed before it impacts premiums?
In the past, the high out-of-pocket cost for testing for mutations in the BRCA1 and BRCA2 genes prevented the test for many women who might otherwise have had it. BRCA testing can determine if a woman’s risk of breast cancer goes beyond the normal 12% to upwards of 70%, in some cases. The test costs around $3,000. The clarification, which comes from the U.S. Department of Health and Human Services, the U.S. Department of Labor, and the U.S. Department of the Treasury, “will allow for BRCA testing to be completed with no patient cost sharing for all non-grandfathered private insurance plans when an asymptomatic woman has a qualifying family history.”
Before you rush out and have the test, take note of the pre-qualifying criteria.
Some tests will be billed to the consumer if they don't meet the genetic testing criteria. We also wonder if these tests will be coded as preventive as long as all results are negative, but diagnostic if there are positive results.
Keep in mind that colonoscopy's are also "free" preventive tests as long as everything is negative. But if an issue is discovered, such as polyps that are removed for biopsy, the exam is no longer preventive but diagnostic. The result is the patient pays the full charge out of their pocket.