Insurance Company Information
This page includes information on several payors and their unique requirements.
Myriad's testing services are reimbursed by hundreds of insurance plans. Although each situation is unique, the average patient pays a coinsurance of less than $100.
Below, we have highlighted a few payors with unique requirements. If you have questions about your specific insurance plan benefits, please call Myriad's customer service at 800-469-7423.
Medicare covers the BRACAnalysis®, COLARIS®, and COLARIS AP® tests when specific medical criteria are met, please review the criteria on the Medicare website. If you need assistance in interpreting the criteria you are encouraged to contact Myriad's Medical Services Department at 800-469-7423. For all Medicare patients that meet Medicare criteria, a copy of the signed informed consent is required before testing will begin. For patients who do not meet Medicare criteria, a signed Advance Beneficiary Notice of Noncoverage (ABN) is required before testing can begin. Medicare will likely not cover test costs for patients who do not meet Medicare criteria. Test costs are then the patient’s responsibility.
Advanced Beneficiary Notice of Non-coverage (ABN) (For Hereditary Cancer)
Advanced Beneficiary Notice of Non-coverage (ABN) (For Personalized Medicine)
United Healthcare requires that BRACAnalysis tests be pre-authorized. Myriad will facilitate the authorization request once the specimen, completed test request form and insurance information is received. Should United Healthcare deny testing, your patient will be notified of any out of pocket expense and payment options before test release.
There are no special requirements for COLARIS and COLARIS AP tests. Relevant personal and family history must be documented on the test request form.
Aetna requires that BRACAnalysis products be pre-authorized. An Aetna Prior Authorization Request Form is required and must be completed by the healthcare provider. Should Aetna deny coverage for testing, your patient will be notified before test release regarding their out-of-pocket expense and payment options.
BART testing is not covered by Aetna at this time and will be the patient’s responsibility. Myriad will contact the patient to provide payment options prior to test release.
COLARIS and COLARIS AP testing is subject to Aetna medical criteria. Should you need assistance interpreting the criteria, please contact Myriad’s Medical Services Department at 800-469-7423. http://www.aetna.com/cpb/medical/data/100_199/0140.html
BCBS - Federal:
Federal plans will not cover testing for unaffected patients. Should the patient want to proceed, Myriad has payment options available. Your office or the patient can file a grievance regarding Federal’s decision regarding no coverage for unaffected patients by contacting the Office of Personnel Management at 202-606-1800 or visit http://www.opm.gov/insure/.