Carefirst and Microarray costs

[Anonymous]

We went to Dr. Rosenbaum and his staff applied to our insurance for pre approval for micro-array testing.

The answer - no pre-approval necessary but also no information as to whether they will cover it or not. They said we could roll the dice and they will decide afterward.

WTF? What SN parent of modest means buys anything with no knowledge of the cost?

WWYD? Thanks so much for any constructive advice. I am hoping there are not any non constructive remarks as I am not

[Anonymous]

I'd look for a more affordable provider or one who can get the insurance pre approved. Or, you will be on the hook for it.

[Anonymous]

Ask the doctor's office what procedure codes they will use for billing. Then ask the insurance company if they will cover those codes.

[Anonymous]

We had the MicroArray done in 2013 with Dr. Rosenbaum. We have CareFirst PPO. The testing was covered. Our portion was very very small.

[Anonymous]

Anonymous wrote:I'd look for a more affordable provider or one who can get the insurance pre approved. Or, you will be on the hook for it.

Well this is everyone's goal, but easier said than done.

OP, we have BCBS and I couldn't get a definitive answer on whether it was pre-approved. We found out at the appointment that none of it was--$4K out of pocket.

[Anonymous]

OP here. Thanks everyone. I am going to call next week. PP, that did not get it covered by BCBS, what year was that?

[Anonymous]

NP - keep in mind different companies BCBS policies cover different things.

[Anonymous]

We never saw a bill for microarray testing for my kid who had significant findings, my spouse or me or my unborn baby. It's more common than you think. We never even did precert. I agree to ask about the code.

[Anonymous]

I went crazy trying to get bcbs to say they would cover it in advance and never got further than 'likely' and in the end it was covered.

Don't know how accurate this is but I was told that its pretty common to have it covered when it comes from a genetics specialist, like Rosenbaum, and sometimes there's more questions about 'medical necessity' when its ordered by a pediatrician or other speciality. Ours was with Dr Zahn (also CNMC).

[Anonymous]

BCBS covered our microarray but not the whole exome testing. But even that may have changed since that was two years ago.

[Anonymous]

Anonymous wrote:BCBS covered our microarray but not the whole exome testing. But even that may have changed since that was two years ago.

Us as well and CNMC got the insurance approvals. It took about 6w just for the approval

[Anonymous]

We saw Dr. Rosenbaum, have Carefirst and also never saw a bill in 2012. Should be covered no problem.

[Anonymous]

Anonymous wrote:We saw Dr. Rosenbaum, have Carefirst and also never saw a bill in 2012. Should be covered no problem.

Wanted to mention that our whole exome was also covered in 2015.

[Anonymous]

Thanks everyone!