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Insurance Coverage for Cancer Genetic Counseling

by Lisa Rezende, PhD

Genetic counseling is recommended for anyone who is concerned that the cancer in their family may be hereditary. Meeting with a genetics expert is an important first step before being tested for a BRCA mutation. FORCE members often ask whether their insurance will cover genetic counseling. While many health insurance plans already cover genetic testing for high-risk women, under health care reform, the Patient Protection and Affordable Care Act requires health insurance plans to cover genetic counseling as a preventive service with no copay or deductible for women whose family history suggests an increased risk of mutations in BRCA1 or BRCA2.

The new law applies to genetic counseling but does not extend to genetic testing. These expanded coverage rules took effect in September 23, 2010 for new, renewed, or amended policies. Policies issued before March 23, 2010 are grandfathered and not required to cover preventative care. If you have questions on how this change affects your own health care coverage, contact your insurance company, state insurance commissioner or the Cancer Legal Resource Center (866-THE-CLRC).


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